Piedmont Community Physicians PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2002-01010 Issued in NC

Legal business name

PIEDMONT COMMUNITY PHYSICIANS PC

Practice address

3610 Darren Rd
Clemmons, NC 27012-9077

Phone

(336) 765-0185

Fax

(336) 768-3636

NPI assigned

Apr 26, 2007

Last updated

Jan 4, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

PIEDMONT COMMUNITY PHYSICIANS, PCAs reported in NPPES

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

Authorized official

Name

Mr. Dickson M Capps

Title

Cao

Phone

(336) 765-0187

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

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

• Piedmont Community Physicians PC

  • Anesthesiology Physician
  • Clemmons, NC
  • NPI 1790998821

  O20040302000782

  Same enrollment
• Piedmont Community Physicians PC

  dba Vein Clinic of NC

  • Phlebology Physician
  • Winston Salem, NC
  • NPI 1871715342

  O20040302000782

  Same enrollment
• Piedmont Community Physicians PC

  • Phlebology Physician
  • Winston Salem, NC
  • NPI 1972915510

  O20040302000782

  Same enrollment
• Piedmont Community Physicians PC

  dba Vein Clinic of North Carolina

  • Phlebology Physician
  • Winston Salem, NC
  • NPI 1982661690

  O20040302000782

  Same enrollment
• Piedmont Community Physicians, PC

  • Family Medicine Physician
  • Clemmons, NC
  • NPI 1790971398

  O20040302000782

  Same enrollment

Part of

Piedmont Pain Care

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Piedmont Community Physicians PC

  dba Vein Clinic of North Carolina

  • Phlebology Physician
  • Winston Salem, NC
  • NPI 1982661690
  NPPES parent name

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515024000000",
    "number": "1821218496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26822",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271146822",
            "telephone_number": "336-765-0185",
            "fax_number": "336-768-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 DARREN RD",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129077",
            "telephone_number": "336-765-0185",
            "fax_number": "336-768-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT COMMUNITY PHYSICIANS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PIEDMONT COMMUNITY PHYSICIANS, PC",
        "enumeration_date": "2007-04-26",
        "last_updated": "2018-01-04",
        "status": "A",
        "authorized_official_last_name": "CAPPS",
        "authorized_official_first_name": "DICKSON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "336-765-0187",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2002-01010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7066710",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2325473A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mariel Pfiffner, MA
• Alma L Pfirman
• Austin Taylor Phillips, PHARM.D., R.PH.
• Jessica Rose Phipps, LCSW
• Piedmont Community Physicians PC
• Piedmont Community Physicians, PC
• Piedmont Medical Solutions, Inc.
• Piedmont Psychiatric Associates PA
• Daniel Avery Pierce
• Clark William Pinyan, MD

• Family Medicine Physician in Clemmons, NC
• Providers in Clemmons, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.