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Piedmont Senior Care, PLLC

Organization Active NPI Geriatric Medicine (Internal Medicine) Physician · Greensboro, NC

NPI 1770566846 · NPPES record last updated Nov 19, 2009

Key facts

NPI
1770566846
Entity type
Organization (NPI type 2)
Primary specialty
Geriatric Medicine (Internal Medicine) Physician 207RG0300X
Legal business name
PIEDMONT SENIOR CARE, PLLC
Practice address
1309 N Elm Street
Greensboro, NC 27401
Phone
(336) 544-5400
Fax
(336) 544-5401
NPI assigned
Nov 22, 2005
Organization subpart
No

Authorized official

Name
Mrs. Amelita Samera Rodriguez
Title
HR/BM
Phone
(336) 544-5400

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 30

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1008173Piedmont Senior Care
1309 North Elm Street, Greensboro, NC 27401		Provider-performed microscopyJan 12, 2027

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207RG0300X NC Yes

Addresses

Primary practice location

1309 N Elm Street
Greensboro, NC 27401

Mailing address

1309 N Elm Street
Greensboro, NC 27401
Phone (336) 544-5400

Other identifiers

IdentifierTypeStateIssuer
89013NHMedicaidNC
013NHOtherNCBLUE CROSS BLUE SHIELD

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 19, 2009.

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258588800000",
    "number": "1770566846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 N ELM STREET",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27401",
            "telephone_number": "336-544-5400",
            "fax_number": "336-544-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 N ELM STREET",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27401",
            "telephone_number": "336-544-5400",
            "fax_number": "336-544-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT SENIOR CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-22",
        "last_updated": "2009-11-19",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "AMELITA",
        "authorized_official_middle_name": "SAMERA",
        "authorized_official_title_or_position": "HR/BM",
        "authorized_official_telephone_number": "336-544-5400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89013NH",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "013NH",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

All providers in Greensboro, NC · Geriatric Medicine (Internal Medicine) Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.