Cornerstone Health Care, LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

CORNERSTONE HEALTH CARE, LLC

Doing business as

Cornerstone Behavioral Medicine @ CPED Premier

Practice address

4515 Premier Dr
Suite 402a
High Point, NC 27265-8357

Phone

(336) 802-2205

Fax

(336) 802-2206

NPI assigned

Nov 8, 2012

Organization subpart

No

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

Authorized official

Name

Charles Douglas Mathis

Title

Chief Administrative Officer

Phone

(336) 802-2536

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cornerstone Behavioral Medicine @ CPED Premier Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

{
    "created_epoch": "1352332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478476800000",
    "number": "1912251232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WESTCHESTER DR",
            "address_2": "SUITE 850",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627008",
            "telephone_number": "336-802-2000",
            "fax_number": "336-802-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 PREMIER DR",
            "address_2": "SUITE 402A",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658357",
            "telephone_number": "336-802-2205",
            "fax_number": "336-802-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-08",
        "last_updated": "2016-11-07",
        "status": "A",
        "authorized_official_last_name": "MATHIS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "336-802-2536"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6008795",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Behavioral Medicine @ CPED Premier",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Cornerstone Health Care, LLC (Cornerstone Behavioral Medicine)
• Cornerstone Health Care, PA (Dale Williams Vascular Medicine/Wound Care Specialist)
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• Counselor in High Point, NC
• Providers in High Point, NC by specialty
• Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; 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.