Forsyth Memorial Hospital Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FORSYTH MEMORIAL HOSPITAL INC

Practice address

1225 Lewisville Clemmons Rd
Lewisville, NC 27023-8251

Phone

(336) 712-0700

Fax

(336) 712-0876

NPI assigned

May 2, 2006

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 MGR

Phone

(704) 303-7517

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Novant Health Lewisville Family Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 1

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

• Alicia Pauley Beal, MD

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1851370845
  NPD

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629244800000",
    "number": "1902864895",
    "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": "704-384-9144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 LEWISVILLE CLEMMONS RD",
            "city": "LEWISVILLE",
            "state": "NC",
            "postal_code": "270238251",
            "telephone_number": "336-712-0700",
            "fax_number": "336-712-0876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORSYTH MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHALA",
        "authorized_official_title_or_position": "RCS MGR",
        "authorized_official_telephone_number": "704-303-7517"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890155W",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA1315",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Lewisville Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Lewisville Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tanya Depetris
• Aleesha L Dunham
• Eckerd Corporation
• Tabitha Ikpechukwu Efobi, DMD
• Vanessa Fitzgerald
• Marie Adelfa Fuller Zurenda, COTA/L
• Teresa Lynn Funk, PHARM D
• Maria Guadalupe Garcia-Toledo, LPC
• Kathleen Glover, NCC, LPC
• April S. Gonzalez, LMBT

• Family Medicine Physician in Lewisville, NC
• Providers in Lewisville, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.