Forsyth Memorial Hospital, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FORSYTH MEMORIAL HOSPITAL, INC

Doing business as

Friedburg Family Medicine

Practice address

5010 Peters Creek Pkwy
Dba Friedburg Family Medicine
Winston Salem, NC 27127-7276

Phone

(336) 788-4664

Fax

(336) 788-0753

NPI assigned

Jan 23, 2007

Last updated

Aug 14, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

FORSYTH MEMORIAL HOSPITAL, INCAs reported in NPPES

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

Authorized official

Name

Michele Grier

Title

VP Operations

Phone

(336) 788-4664

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Friedburg Family Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Part of

Novant Health

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218672000000",
    "number": "1912051939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 FRONTIS PLAZA BLVD STE 102",
            "address_2": "FORSYTH MEDICAL GROUP, LLC",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035616",
            "telephone_number": "336-788-4664",
            "fax_number": "336-788-0753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 PETERS CREEK PKWY",
            "address_2": "DBA FRIEDBURG FAMILY MEDICINE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271277276",
            "telephone_number": "336-788-4664",
            "fax_number": "336-788-0753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORSYTH MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FORSYTH MEMORIAL HOSPITAL, INC",
        "enumeration_date": "2007-01-23",
        "last_updated": "2008-08-14",
        "status": "A",
        "authorized_official_last_name": "GRIER",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "VP OPERATIONS",
        "authorized_official_telephone_number": "336-788-4664"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "019C9",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906033",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Friedburg Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Forsyth Memorial Hospital, Inc (Premier Medical Associates)
• Forsyth Memorial Hospital, Inc (Novant Inpatient Care Specialists - Forsyth)
• Forsyth Memorial Hospital, Inc (Arcadia Family Practice)
• Forsyth Memorial Hospital, Inc (Salem Family Practice at Gateway)
• Forsyth Memorial Hospital, Inc (Novant Health Inpatient Specialty Services)
• Forsyth Memorial Hospital, Inc. (NH Forsyth Primary Care Clinics)
• Forsyth Memorial Hospital, Inc. (NH Forsyth Specialty Clinics)
• Forsyth Memorial Hospital, Inc. (Novant Health Forsyth Behavioral Health)
• Forsyth Memorial Hospital, Inc. (FMC Professional Fees)
• Forsyth Memorial Hospital, Inc. (FMC Rehabilitation)

• Family Medicine Physician in Winston Salem, NC
• Providers in Winston Salem, 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 14, 2008; 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.