Forsyth Memorial Hospital, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

FORSYTH MEMORIAL HOSPITAL, INC

Practice address

105 Stadium Oaks Dr
Clemmons, NC 27012-8962

Phone

(336) 766-0547

NPI assigned

Mar 13, 2007

Organization subpart

No

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

Authorized official

Name

Shala Davis

Title

RCS Manager

Phone

(704) 303-7517

Specialties & licenses 3

Addresses

Other names 1

• West Forsyth Internal Medicine & Pediatrics Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 2

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

• Jan Elisa Rogers, FNP

  • Nurse Practitioner
  • Mocksville, NC
  • NPI 1356741102
  NPD
• Christopher John Warnimont, MD

  • Internal Medicine Physician
  • Clemmons, NC
  • NPI 1760485486
  NPD

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689120000000",
    "number": "1891828562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-718-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 STADIUM OAKS DR",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128962",
            "telephone_number": "336-766-0547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORSYTH MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2023-07-12",
        "certification_date": "2021-08-16",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHALA",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "704-303-7517"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Forsyth Internal Medicine & Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alissa Foote, PT
• Forsyth Memorial Hospital
• Forsyth Memorial Hospital Inc
• Forsyth Memorial Hospital Inc
• Forsyth Memorial Hospital, Inc
• Forsyth Memorial Hospital, Inc.
• Forsyth Psychiatric Associates, PLLC
• Foster Chiropractic Clinic
• Amy Diachenko Foster, M.A.
• Foundation Health Systems Corp

• Internal Medicine Physician in Clemmons, NC
• Providers in Clemmons, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.