Individual provider Active NPI

John D. Patrick, M.D.

  • Specialist
  • Greensboro, NC
National Provider Identifier
1861487902
Registry record updated Apr 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
33415 Issued in NC
Practice address
501 N Elam Ave
Greensboro, NC 27403-1118
Phone
(336) 271-4930
Fax
(336) 271-8466
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 33415 NC Primary

Addresses

Primary practice location

501 N Elam Ave
Greensboro, NC 27403-1118

Mailing address

PO Box 13508
Greensboro, NC 27415-3508
Phone (336) 271-4930

Other identifiers 1

IdentifierTypeStateIssuer
220023044OtherNCRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100218000433 NC Practitioner - Pathology 0749324416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of South Carolina School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greensboro Pathology, LLCGroup PAC ID 1153315643, 18 clinicians

Practice addresses (Care Compare)

706 Green Valley Rd
Suite 104
Greensboro, NC 27408-7043
Phone (336) 387-2500

Hospital & facility affiliations

  • Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091
  • Northern Regional Hospital Hospital, Mount Airy, NC, CCN 340003
  • Alamance Regional Medical Center Hospital, Burlington, NC, CCN 340070
  • Randolph Hospital Hospital, Asheboro, NC, CCN 340123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33415NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Atlantic Pathology Services, Inc. Current Accepting new patients
Greensboro Pathology, LLC CurrentSince Mar 1, 1998 Accepting new patients
Greensboro Pathology, LLC Specialist CurrentSince Mar 1, 1998 Accepting new patients

Locations

11025 Rca Center Dr
Ste 300
Palm Beach Gardens, FL 33410
Phone (561) 383-3820

706 Green Valley Rd
Ste 104
Greensboro, NC 27408
Phone (336) 271-4930

2400 W Friendly Ave
Greensboro, NC 27403
Phone (336) 832-1100

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1861487902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13508",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274153508",
            "telephone_number": "336-271-4930",
            "fax_number": "336-271-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N ELAM AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031118",
            "telephone_number": "336-271-4930",
            "fax_number": "336-271-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "JOHN",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "33415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "220023044",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.