NPIMap

Organization Active NPI

Moses Cone Affiliated Physicians, Inc.

  • Cardiovascular Disease Physician
  • Burlington, NC
National Provider Identifier
1972949949
Registry record updated May 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
MOSES CONE AFFILIATED PHYSICIANS, INC.
Practice address
1611 Flora Ave
Burlington, NC 27217-1017
Phone
(336) 270-5622
NPI assigned
May 17, 2013
Organization subpart
Yes
Parent organization
THE MOSES H. CONE MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 17, 2013

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

Authorized official

Name
Robert Lee Goldstein
Title
Executive Vice President
Phone
(336) 832-6250

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

1611 Flora Ave
Burlington, NC 27217-1017

Mailing address

1611 Flora Ave
Burlington, NC 27217-1017
Phone (336) 270-5622

Other names 1

  • Glen Raven Medical Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090713000512 NC Part B Supplier - Clinic/Group Practice 3779635396 Receives reassigned benefits from 86 practitioners
35 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greensboro, NC; Reidsville, NC; Oak Ridge, NC; Kernersville, NC; High Point, NC; Burlington, NC; Asheboro, NC

Other NPIs on the same Medicare enrollment 35

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

View all 35

National Provider Directory

National Provider Directory
Part of
Moses Cone Mem Hosp

Interoperability endpoints

  • Direct secure messaging: javedmasoud@grm.allscriptsdirect.net

NPI Registry JSON

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

{
    "created_epoch": "1368748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368748800000",
    "number": "1972949949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 FLORA AVE",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272171017",
            "telephone_number": "336-270-5622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 FLORA AVE",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272171017",
            "telephone_number": "336-270-5622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSES CONE AFFILIATED PHYSICIANS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE MOSES H. CONE MEMORIAL HOSPITAL",
        "enumeration_date": "2013-05-17",
        "last_updated": "2013-05-17",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "336-832-6250"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glen Raven Medical Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burlington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2013; 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.