NPIMap

North Carolina Baptist Hospital

Organization Active NPI Community/Retail Pharmacy · Winston Salem, NC

NPI 1801917364 · NPPES record last updated Oct 24, 2019

Key facts

NPI
1801917364
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
07099 (NC)
Legal business name
NORTH CAROLINA BAPTIST HOSPITAL
Practice address
1200 N Martin Luther King Jr Dr
Winston Salem, NC 27101-3006
Phone
(336) 713-9677
Fax
(336) 713-9529
NPI assigned
Apr 3, 2007
Organization subpart
No

Authorized official

Name
Regina H Schomberg, PHARMD, BCPS
Title
Director of Pharmacy
Phone
(336) 713-3421

Owned or controlled facilities with NPI records 11

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 6

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

Other NPIs with the same Medicare PAC ID 11

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

Corporate family (same tax ID) 28

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

View all 28

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
34D2268733Downtown Health Plaza Pharmacy
1200 N Martin Luther King Jr Dr, Winston-Salem, NC 27101		Certificate of waiverSep 15, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in NC

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Wilkes Regional Medical Center
North Wilkesboro, NC · CCN 340064		 Hospital 5% Or Greater Indirect Ownership Interest (40%) Oct 9, 2020
North Carolina Baptist Hospital
Winston Salem, NC · CCN 340047		 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 9, 2020
High Point Medical Center
High Point, NC · CCN 340004		 Hospital 5% Or Greater Indirect Ownership Interest (40%) Oct 9, 2020
Lexington Medical Center
Lexington, NC · CCN 340096		 Hospital 5% Or Greater Indirect Ownership Interest (40%) Oct 9, 2020
High Point Medical Center
High Point, NC · CCN 34T004		 Hospital 5% Or Greater Indirect Ownership Interest (40%) Oct 9, 2020
North Carolina Baptist Hospital
Winston Salem, NC · CCN 34T047		 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 9, 2020
North Carolina Baptist Hospital
Winston Salem, NC · CCN 34S047		 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 9, 2020
North Carolina Baptist Hospital
Winston Salem, NC · CCN 342304		 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 9, 2020
Wilkes Regional Medical Center SNF
North Wilkesboro, NC · CCN 345386		 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (40%) Jul 1, 2017

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200813002886 NC Part B Supplier - Pharmacy 6002725272 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winston Salem, NC; Clemmons, NC; Bermuda Run, NC
O20200916000271 NC Part B Supplier - Mass Immunization (Roster Biller Only) 6002725272 Practice locations: Winston Salem, NC

National Provider Directory

Tax ID family
North Carolina Baptist H (29 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 07099 NC Yes

Addresses

Primary practice location

1200 N Martin Luther King Jr Dr
Winston Salem, NC 27101-3006

Mailing address

1200 N Martin Luther King Jr Dr
Winston Salem, NC 27101-3006
Phone (336) 713-9677

Other identifiers

IdentifierTypeStateIssuer
0346972MedicaidNC

Other names

  • DOWNTOWN HEALTH PLAZA PHARMACY Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 24, 2019.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571875200000",
    "number": "1801917364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N MARTIN LUTHER KING JR DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013006",
            "telephone_number": "336-713-9677",
            "fax_number": "336-713-9529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N MARTIN LUTHER KING JR DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013006",
            "telephone_number": "336-713-9677",
            "fax_number": "336-713-9529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA BAPTIST HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2019-10-24",
        "status": "A",
        "authorized_official_last_name": "SCHOMBERG",
        "authorized_official_first_name": "REGINA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "336-713-3421",
        "authorized_official_credential": "PHARMD, BCPS"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "07099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0346972",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOWNTOWN HEALTH PLAZA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DOWNTOWN HEALTH PLAZA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

All providers in Winston Salem, NC · Community/Retail Pharmacy in North Carolina

Sources for this page

Verify at the official NPI Registry.