NPIMap

Organization Active NPI

Unc Rockingham Health Care, Inc.

Doing business as Rockingham County High School Student Health Center

  • Pediatric Adolescent Medicine Physician
  • Reidsville, NC
National Provider Identifier
1801921390
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
200400651 Issued in NC
Legal business name
UNC ROCKINGHAM HEALTH CARE, INC.
Doing business as
Rockingham County High School Student Health Center
Practice address
180 High School Rd
Reidsville, NC 27320-8889
Phone
(336) 634-3201
Fax
(336) 634-3201
NPI assigned
Feb 23, 2007
Last updated
Jul 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Authorized official

Name
Karen Ann Shadowens
Title
Cfo, VP
Phone
(336) 627-8512

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 200698 NC
Pediatric Nurse Practitioner 363LP0200X 300219 NC
Registered Nurse 163W00000X 61720 NC
Registered Nurse 163W00000X 70791 NC
Obstetrics & Gynecology Physician 207V00000X 00-35434 NC
Pediatric Adolescent Medicine Physician 2080A0000X 200400651 NC Primary

Addresses

Primary practice location

180 High School Rd
Reidsville, NC 27320-8889

Mailing address

117 E Kings Hwy
Eden, NC 27288-5201
Phone (336) 623-9711

Other identifiers 1

IdentifierTypeStateIssuer
7000803MedicaidNC

Other names 1

  • Rockingham County High School Student Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Morehead Memorial Hospita13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

180 High School Rd
Reidsville, NC 27320
Phone (336) 634-3201

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689552000000",
    "number": "1801921390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E KINGS HWY",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885201",
            "telephone_number": "336-623-9711",
            "fax_number": "336-623-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 HIGH SCHOOL RD",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273208889",
            "telephone_number": "336-634-3201",
            "fax_number": "336-634-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNC ROCKINGHAM HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A",
        "authorized_official_last_name": "SHADOWENS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CFO, VP",
        "authorized_official_telephone_number": "336-627-8512"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "200698",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "300219",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "61720",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "70791",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "00-35434",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NC",
            "license": "200400651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7000803",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rockingham County High School Student Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rockingham County High School Student Health Center",
            "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 Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.