NPIMap

Organization Active NPI

Piedmont Community Physicians PC

  • Phlebology Physician
  • Winston Salem, NC
National Provider Identifier
1972915510
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebology PhysicianTaxonomy code 202K00000X
Legal business name
PIEDMONT COMMUNITY PHYSICIANS PC
Practice address
3318 Healy Dr
Winston Salem, NC 27103-1404
Phone
(336) 768-3530
Fax
(336) 768-3636
NPI assigned
Jun 2, 2014
Last updated
Aug 17, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
PIEDMONT COMMUNITY PHYSICIANS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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

Authorized official

Name
Dana Capps Moody
Title
Practice Administrator
Phone
(336) 768-3530

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 202K00000X Primary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 2002-01010 NC

Addresses

Primary practice location

3318 Healy Dr
Winston Salem, NC 27103-1404

Mailing address

3318 Healy Dr
Winston Salem, NC 27103-1404
Phone (336) 768-3530

Other practice location 1

3610 Darren Rd
Clemmons, NC 27012-9077
Phone (336) 765-0187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040302000782 NC Part B Supplier - Clinic/Group Practice 4082500319 Receives reassigned benefits from 1 practitioner
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winston Salem, NC

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Piedmont Pain Care

Locations

9852 Rea Rd
Ste G2
Charlotte, NC 28277
Phone (704) 540-2772

6580 Shallowford Rd
Lewisville, NC 27023
Phone (336) 945-2076

105 S Main St
Marion, NC 28752
Phone (828) 652-7086

63 S Medical Ct
#B
Marion, NC 28752
Phone (828) 652-9067

145 Kimel Park Dr
Ste 300
Winston Salem, NC 27103
Phone (336) 768-3212

145 Kimel Park Dr
Ste 320
Winston Salem, NC 27103
Phone (336) 714-6400

1901 S Hawthorne Rd
Ste 340
Winston Salem, NC 27103
Phone (336) 765-6277

3030 Trenwest Dr
Ste 102
Winston Salem, NC 27103
Phone (336) 768-3530

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 55

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 55

NPI Registry JSON

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660694400000",
    "number": "1972915510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3318 HEALY DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031404",
            "telephone_number": "336-768-3530",
            "fax_number": "336-768-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3318 HEALY DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031404",
            "telephone_number": "336-768-3530",
            "fax_number": "336-768-3636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3610 Darren Rd",
            "address_purpose": "LOCATION",
            "city": "Clemmons",
            "state": "NC",
            "postal_code": "270129077",
            "country_code": "US",
            "telephone_number": "336-765-0187",
            "fax_number": "336-768-3636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PIEDMONT COMMUNITY PHYSICIANS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PIEDMONT COMMUNITY PHYSICIANS, PC",
        "enumeration_date": "2014-06-02",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "CAPPS",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "336-768-3530"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Phlebology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2002-01010",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; 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.