NPIMap

Organization Active NPI

Surry Regional Health Services

  • Pediatrics Physician
  • Mount Airy, NC
National Provider Identifier
1881682136
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SURRY REGIONAL HEALTH SERVICES
Practice address
100 North Pointe Boulevard
Mount Airy, NC 27030-4419
Phone
(336) 789-6267
Fax
(336) 786-4245
NPI assigned
Oct 11, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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

Authorized official

Name
Mr. William James
Title
Chief Executive Officer
Phone
(336) 719-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

100 North Pointe Boulevard
Mount Airy, NC 27030-4419

Mailing address

PO Box 1267
Mount Airy, NC 27030-1267
Phone (336) 786-4522

Other identifiers 1

IdentifierTypeStateIssuer
790231AMedicaidNC

Other names 1

  • Northern Pediatric Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Crnas of Mount Airy8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389657600000",
    "number": "1881682136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1267",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270301267",
            "telephone_number": "336-786-4522",
            "fax_number": "336-789-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NORTH POINTE BOULEVARD",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270304419",
            "telephone_number": "336-789-6267",
            "fax_number": "336-786-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURRY REGIONAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2014-01-14",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "336-719-7000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "790231A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Pediatric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Airy, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; 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.