NPIMap

Organization Active NPI

Moses Cone Physician Services Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Reidsville, NC
National Provider Identifier
1780004556
Registry record updated May 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
MOSES CONE PHYSICIAN SERVICES INC
Practice address
1107 S Main St
Reidsville, NC 27320-5313
Phone
(336) 951-6070
Fax
(336) 634-3940
NPI assigned
Apr 21, 2014
Organization subpart
Yes
Parent organization
THE MOSES H. CONE MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 9, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Robert Lee Goldstein
Title
Executive Vice President
Phone
(336) 832-6250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

1107 S Main St
Reidsville, NC 27320-5313

Mailing address

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-7764

Other names 1

  • Reidsville Endocrinology Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140714001637 NC Part B Supplier - Clinic/Group Practice 4284782210 Receives reassigned benefits from 82 practitioners
3 other NPIs on this enrollment
Practice locations: Burlington, NC; Reidsville, NC; Mebane, NC; Greensboro, NC; Graham, NC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2080482Reidsville Endocrinology Associates1107 South Main Street, Reidsville, NC 27320Certificate of waiverJul 7, 2026

National Provider Directory

National Provider Directory
Tax ID family
Moses Cone Physician Services Inc15 organizations share this tax ID, including this one
Part of
Moses Cone Mem Hosp

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

1107 S Main St
Reidsville, NC 27320
Phone (336) 348-6664

Practitioners & affiliated clinicians

Practitioners 455

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

View all 455

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399593600000",
    "number": "1780004556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011004",
            "telephone_number": "336-832-7764",
            "fax_number": "336-832-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 S MAIN ST",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205313",
            "telephone_number": "336-951-6070",
            "fax_number": "336-634-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSES CONE PHYSICIAN SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE MOSES H. CONE MEMORIAL HOSPITAL",
        "enumeration_date": "2014-04-21",
        "last_updated": "2014-05-09",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "336-832-6250"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reidsville Endocrinology Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reidsville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.