Active NPI
Malcolm Truman Stark Jr., M.D.
- Gastroenterology Physician
- Greensboro, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 35521
- Practice address
- 520 N Elam Ave
Greensboro, NC 27403-1127 - Phone
- (336) 547-1700
- NPI assigned
- May 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35521 | NC | |
| Gastroenterology Physician | 207RG0100X | 35521 | NC | Primary |
Addresses
Primary practice location
520 N Elam Ave
Greensboro, NC 27403-1127
Mailing address
1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-7000
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4238777 | Other | NC | AETNA |
| 8979130 | Medicaid | NC | |
| 2109 | Other | NC | PARTNERS MEDICARE |
| 42358 | Other | NC | MEDCOST |
| 79365 | Other | NC | BCBS NC |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mstark3879@direct.conehealth.com | Direct |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moses Cone Medical Services, Inc. | Current | Accepting new patients | |
| Moses Cone Medical Services, Inc. | Internal Medicine | Current | Accepting new patients |
Locations
300 E Wendover Ave
Fl 4
Greensboro, NC 27401
Phone (336) 663-5038
1126 N Church St
Ste 300
Greensboro, NC 27401
Phone (336) 547-1700
520 N Elam Ave
Greensboro, NC 27403
Phone (336) 475-7148
301 E Wendover Ave
Ste 411
Greensboro, NC 27401
Phone (336) 832-3200
1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000
940 Golf House Ct E
Whitsett, NC 27377
Phone (336) 449-9848
Interoperability endpoints
- mstark3879@direct.conehealth.com
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Greensboro, NC
- NPI 1427095249
-
- Family Medicine Physician
- Madison, NC
- NPI 1629376363
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632096000000",
"number": "1891745261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 N ELM ST",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274011004",
"telephone_number": "336-832-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 N ELAM AVE",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274031127",
"telephone_number": "336-547-1700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STARK",
"first_name": "MALCOLM",
"middle_name": "TRUMAN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2021-09-20",
"certification_date": "2021-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NC",
"license": "35521",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NC",
"license": "35521",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4238777",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8979130",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS MEDICARE",
"identifier": "2109",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "42358",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NC",
"identifier": "79365",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mstark3879@direct.conehealth.com",
"affiliation": "N",
"endpointDescription": "Cone Health Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "520 N Elam Ave",
"city": "Greensboro",
"state": "NC",
"country_code": "US",
"postal_code": "274031127",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.