Piedmont Community Physicians PC

Primary specialty

Phlebology PhysicianTaxonomy code 202K00000X

License

1991-34813 Issued in NC

Legal business name

PIEDMONT COMMUNITY PHYSICIANS PC

Practice address

3318 Healy Dr
Winston Salem, NC 27103-1404

Phone

(336) 768-3530

Fax

(336) 768-1329

NPI assigned

May 3, 2007

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

Dana Capps Moody

Title

Practice Administrator

Phone

(336) 768-3530

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Vein Clinic of NC Doing business as

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

  • Family Medicine Physician
  • Clemmons, NC
  • NPI 1821218496

  O20040302000782

  Same enrollment
• Piedmont Community Physicians PC

  • Phlebology Physician
  • Winston Salem, NC
  • NPI 1972915510

  O20040302000782

  Same enrollment
• Piedmont Community Physicians PC

  • 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

Medical Alliance Clinic

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

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

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Scott William Baker, M.D.

  • Phlebology Physician
  • Winston Salem, NC
  • NPI 1104884279
  NPD
• George William Haggerson, M.D.

  • Surgery Physician
  • Winston Salem, NC
  • NPI 1114984267
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660694400000",
    "number": "1871715342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3318 HEALY DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031404",
            "telephone_number": "336-768-3530",
            "fax_number": "336-768-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3318 HEALY DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031404",
            "telephone_number": "336-768-3530",
            "fax_number": "336-768-1329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT COMMUNITY PHYSICIANS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PIEDMONT COMMUNITY PHYSICIANS, PC",
        "enumeration_date": "2007-05-03",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "CAPPS",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "336-768-3530"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Phlebology",
            "state": "NC",
            "license": "22664",
            "primary": false
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Phlebology",
            "state": "NC",
            "license": "1991-34813",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NC",
            "license": "17432",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NC",
            "license": "34813",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSBC NC",
            "identifier": "13217",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9209243",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vein Clinic of NC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vein Clinic of NC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Charis Pickett
• Stephanie Pickett, ANP-C
• Mhorys Kenneth Pickmans, M.D.
• Piedmont Behavioral Counseling Center
• Piedmont Clinic, PLLC
• Piedmont Community Physicians PC
• Piedmont Community Physicians PC
• Piedmont Cosmetic Surgery and Dermatology Center, PA
• Piedmont Dialysis Center of Wake Forest University
• Piedmont Ear, Nose & Throat Associates, P.a.

• Phlebology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Phlebology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; 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.