General Medical Clinic, PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

9700286 Issued in NC

Legal business name

GENERAL MEDICAL CLINIC, PA

Practice address

2003 Boulevard St Ste C
Greensboro, NC 27407-4579

Phone

(336) 633-0407

Fax

(336) 633-0410

NPI assigned

Jul 1, 2006

Organization subpart

No

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

Authorized official

Name

Tarshia Donnell

Title

Regional Director

Phone

(336) 301-4264

Specialties & licenses 6

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• General Medical Clinic,PA

  • Primary Care Clinic/Center
  • Durham, NC
  • NPI 1952543688
  NPPES parent name

Practitioners 9

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.

• Janis Panzenhagen Puglisi, PHD, APRN, FNP-BC

  • Nurse Practitioner
  • High Point, NC
  • NPI 1114017498

  Family

  Medicare reassignment NPD
• David Richard Courtemanche, P.A.-C.

  • Physician Assistant
  • Winston Salem, NC
  • NPI 1285772798
  Medicare reassignment
• Elizabeth Ashely Margaret Holler, PA-C

  • Medical Physician Assistant
  • Morrisville, NC
  • NPI 1043508633
  Medicare reassignment
• Malia Allegra Lonergan, PA-C

  • Medical Physician Assistant
  • Greensboro, NC
  • NPI 1639570823
  Medicare reassignment
• Edward Saguier, P.A.

  • Medical Physician Assistant
  • Asheboro, NC
  • NPI 1154300713
  Medicare reassignment
• David Campbell Gerlach, M.D.

  • Internal Medicine Physician
  • Atchison, KS
  • NPI 1659464949
  NPD
• Clancy Conde Laizure, PA

  • Surgical Physician Assistant
  • Summerfield, NC
  • NPI 1598791147
  NPD (past)
• David Odell Mabe, FNPC

  • Family Nurse Practitioner
  • Greensboro, NC
  • NPI 1821127796
  NPD (past)
• Michaella Walton

  • Clinical Social Worker
  • Greensboro, NC
  • NPI 1841803178

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1871522003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274020788",
            "telephone_number": "336-301-4264",
            "fax_number": "336-633-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 BOULEVARD ST STE C",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274074579",
            "telephone_number": "336-633-0407",
            "fax_number": "336-633-0410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 Foust St",
            "address_purpose": "LOCATION",
            "city": "Asheboro",
            "state": "NC",
            "postal_code": "272035404",
            "country_code": "US",
            "telephone_number": "336-633-0407",
            "fax_number": "336-633-0410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GENERAL MEDICAL CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A",
        "authorized_official_last_name": "DONNELL",
        "authorized_official_first_name": "TARSHIA",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR",
        "authorized_official_telephone_number": "336-301-4264"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "9700286",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902980",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Scott Geiple, PA-C
• Kelly Gekas, PA-C
• Kristin Marie Gellert, OTR/L
• Mary Coleen Gelmann, CRNA
• Gems First Stop Medical Solutions, LLC (First Stop Med)
• Generations Family Practice, PA (Triad Primary Care)
• Genesis Community Support Services, LLC
• Genesis Medical Practice, PLLC
• Genesis Mind Care
• Geneva's Touch Home Care Agency, LLC

• Primary Care Clinic/Center in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Primary Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.