NPIMap

Organization Active NPI

Stanly Medical Services

Doing business as Stanly Pediatric Services at Locust

  • Pediatrics Physician
  • Locust, NC
National Provider Identifier
1821079963
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
STANLY MEDICAL SERVICES
Doing business as
Stanly Pediatric Services at Locust
Practice address
103 Stanly Pkwy
Ste a
Locust, NC 28097-7704
Phone
(704) 888-8445
Fax
(704) 888-8456
NPI assigned
Nov 7, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Douglas Scott Forth
Title
Ceo
Phone
(704) 983-8756

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

103 Stanly Pkwy
Ste a
Locust, NC 28097-7704

Mailing address

320 Yadkin St
Ste B
Albemarle, NC 28001-3447
Phone (704) 982-0639

Other names 1

  • Stanly Pediatric Services at Locust Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Stanly Medical Services5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821079963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 YADKIN ST",
            "address_2": "STE B",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013447",
            "telephone_number": "704-982-0639",
            "fax_number": "704-983-6153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 STANLY PKWY",
            "address_2": "STE A",
            "city": "LOCUST",
            "state": "NC",
            "postal_code": "280977704",
            "telephone_number": "704-888-8445",
            "fax_number": "704-888-8456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANLY MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FORTH",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-983-8756"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stanly Pediatric Services at Locust",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Locust, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.