| Eagle Family Medicine @ Guilford College | |
|
1210 New Garden Rd Greensboro NC 27410-2721 | |
| (336) 294-6190 | |
| (336) 294-6278 |
| Full Name | Eagle Family Medicine @ Guilford College |
|---|---|
| Speciality | Family Medicine |
| Location | 1210 New Garden Rd, Greensboro, North Carolina |
| Authorized Official Name and Position | Terri S. Jones (DIRECTOR, EAGLE BUSINESS SERVICES) |
| Authorized Official Contact | 3362683201 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Family Medicine @ Guilford College Po Box 14883 Greensboro NC 27415-4883 Ph: (336) 294-6190 | Eagle Family Medicine @ Guilford College 1210 New Garden Rd Greensboro NC 27410-2721 Ph: (336) 294-6190 |
| NPI Number | 1457436982 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 07/26/2016 |
| Medicare PECOS PAC ID | 0244134468 |
|---|---|
| Medicare Enrollment ID | O20031120000436 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457436982 | NPI | - | NPPES |
| 890134X | Medicaid | NC | |
| 0134X | Other | NC | BCBS OF NC GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Ronald D Polite |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689775470 PECOS PAC ID: 3870490477 Enrollment ID: I20031212000568 |
| Provider Name | Shanna G Stoter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1205818564 PECOS PAC ID: 4183522600 Enrollment ID: I20031222000586 |
| Provider Name | Jeffrey S Kerr |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1477649721 PECOS PAC ID: 5698677060 Enrollment ID: I20040126000187 |
| Provider Name | Albert K Bartko |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1447291661 PECOS PAC ID: 8628969474 Enrollment ID: I20040322001886 |
| Provider Name | John F Redding |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215978739 PECOS PAC ID: 4981692316 Enrollment ID: I20040504001438 |
| Provider Name | Cammie Jo Fulp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558364828 PECOS PAC ID: 3971581380 Enrollment ID: I20040712001166 |
| Provider Name | Salem F Ganem |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1568543833 PECOS PAC ID: 3375523913 Enrollment ID: I20040723000168 |
| Provider Name | James A Miller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699810382 PECOS PAC ID: 5597736595 Enrollment ID: I20040803001617 |
| Provider Name | Heather S Waddell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1366427858 PECOS PAC ID: 5395719900 Enrollment ID: I20040820000291 |
| Provider Name | Rachel H Hagler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396718482 PECOS PAC ID: 5193799922 Enrollment ID: I20040825001445 |
| Provider Name | Cheryl Day White |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1326085622 PECOS PAC ID: 4880507847 Enrollment ID: I20040923000281 |
| Provider Name | William M Outlaw |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346353315 PECOS PAC ID: 9638131493 Enrollment ID: I20041103000428 |
| Provider Name | David S Swayne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891723961 PECOS PAC ID: 4789634882 Enrollment ID: I20050126000909 |
| Provider Name | Vyvyan Ye-lin Sun |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851328785 PECOS PAC ID: 9638120140 Enrollment ID: I20050202000256 |
| Provider Name | Karen Susan Glass |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639120058 PECOS PAC ID: 8022003102 Enrollment ID: I20050614001392 |
| Provider Name | Alvin J Lue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235191099 PECOS PAC ID: 4880630862 Enrollment ID: I20050629001011 |
| Provider Name | Maria A Ibarra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205818473 PECOS PAC ID: 3577596352 Enrollment ID: I20050913000404 |
| Provider Name | Rupashree V Varadarajan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144250820 PECOS PAC ID: 4981629078 Enrollment ID: I20051011000338 |
| Provider Name | Alysia Preslar |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1811938913 PECOS PAC ID: 1658398052 Enrollment ID: I20051025000822 |
| Provider Name | Lisa Anne Rieker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1841231412 PECOS PAC ID: 9133142284 Enrollment ID: I20060104000636 |
| Provider Name | Auma N Thongteum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871584953 PECOS PAC ID: 3476562554 Enrollment ID: I20060418000569 |
| Provider Name | Stephen M Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962427021 PECOS PAC ID: 2769485473 Enrollment ID: I20060818000469 |
| Provider Name | Tara Janelle Cole |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891713699 PECOS PAC ID: 3375548456 Enrollment ID: I20060922000551 |
| Provider Name | Sharon Aberin Wolters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467498980 PECOS PAC ID: 8527063379 Enrollment ID: I20060929000233 |
| Provider Name | Vincent C Schooler |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1467479204 PECOS PAC ID: 2163429960 Enrollment ID: I20061108000189 |
| Provider Name | Benita W Varnado |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073620159 PECOS PAC ID: 2163420290 Enrollment ID: I20061218000520 |
| Provider Name | Joseph A Joyce |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518938257 PECOS PAC ID: 7618977711 Enrollment ID: I20070112000180 |
| Provider Name | Samandra N Tann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093830291 PECOS PAC ID: 0547368524 Enrollment ID: I20070614000665 |
| Provider Name | Carl Joseph Szczesniak |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1922082510 PECOS PAC ID: 3274573381 Enrollment ID: I20070620000022 |
| Provider Name | Andrew D Michels |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720048135 PECOS PAC ID: 0840390498 Enrollment ID: I20070711000522 |
| Provider Name | Carroll C Spinks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932287232 PECOS PAC ID: 9638262843 Enrollment ID: I20070904000690 |
| Provider Name | Patricia Porteous Fletcher |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1548452238 PECOS PAC ID: 7416040555 Enrollment ID: I20070906000406 |
| Provider Name | Elizabeth M Mulberry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043398969 PECOS PAC ID: 3678669371 Enrollment ID: I20071010000747 |
| Provider Name | Renea W Shore |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760677850 PECOS PAC ID: 3072601004 Enrollment ID: I20071108000528 |
| Provider Name | Janice F Weatherly |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1346436102 PECOS PAC ID: 8426146457 Enrollment ID: I20071108000543 |
| Provider Name | Deborah D Schoenhoff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134153471 PECOS PAC ID: 3678662004 Enrollment ID: I20071207000471 |
| Provider Name | Jessica W Brown |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1457534208 PECOS PAC ID: 4587744214 Enrollment ID: I20080107000689 |
| Provider Name | Robert S Wilkins |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1801073424 PECOS PAC ID: 7911081864 Enrollment ID: I20080301000021 |
| Provider Name | Janice Daniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528021177 PECOS PAC ID: 4587734520 Enrollment ID: I20080603000675 |
| Provider Name | Kelly A Tonkin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356590152 PECOS PAC ID: 7416025754 Enrollment ID: I20081014000232 |
| Provider Name | Elizabeth Stewar Barnes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629015326 PECOS PAC ID: 2961416938 Enrollment ID: I20081204000997 |
| Provider Name | Patricia L Hill |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1104902840 PECOS PAC ID: 0244395119 Enrollment ID: I20090210000667 |
| Provider Name | Tammy Mullins Jividen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922251628 PECOS PAC ID: 3577624998 Enrollment ID: I20090724000650 |
| Provider Name | Dibas Koirala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417187790 PECOS PAC ID: 7416003264 Enrollment ID: I20090918000340 |
| Provider Name | Betty G Jordan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811197320 PECOS PAC ID: 1951442680 Enrollment ID: I20100104000330 |
| Provider Name | Monica E Doerr |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1952337271 PECOS PAC ID: 3072655539 Enrollment ID: I20100121000227 |
| Provider Name | Ryan A Holton |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1346574100 PECOS PAC ID: 7810031267 Enrollment ID: I20100223000365 |
| Provider Name | Brian L Miller |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609854454 PECOS PAC ID: 3072507045 Enrollment ID: I20100306000085 |
| Provider Name | William C Wall |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902138894 PECOS PAC ID: 1759418932 Enrollment ID: I20100420000434 |
| Provider Name | James C Osborne |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1922177013 PECOS PAC ID: 4981600335 Enrollment ID: I20100423000442 |
| Provider Name | Robert R Ehinger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831268796 PECOS PAC ID: 8325176787 Enrollment ID: I20100506000185 |
| Provider Name | Robert V Buccini |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1861573107 PECOS PAC ID: 7517095870 Enrollment ID: I20100506000288 |
| Provider Name | Carola J Westermann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700972866 PECOS PAC ID: 2062540339 Enrollment ID: I20100506000402 |
| Provider Name | Elaine Griffin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700955671 PECOS PAC ID: 9830227107 Enrollment ID: I20100506000459 |
| Provider Name | Robert Fried |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013095330 PECOS PAC ID: 4385734474 Enrollment ID: I20100506000482 |
| Provider Name | Lewis D Mitchell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124197090 PECOS PAC ID: 8921198011 Enrollment ID: I20100506000755 |
| Provider Name | John J Griffin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689753923 PECOS PAC ID: 1456489756 Enrollment ID: I20100506000781 |
| Provider Name | Donna R Gates |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316033657 PECOS PAC ID: 9032247333 Enrollment ID: I20100506000844 |
| Provider Name | Hal T Stoneking |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952470056 PECOS PAC ID: 2668562752 Enrollment ID: I20100506000980 |
| Provider Name | Stephen Meyers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821176157 PECOS PAC ID: 7214065531 Enrollment ID: I20100506000982 |
| Provider Name | Robert Reade |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356372833 PECOS PAC ID: 3870621196 Enrollment ID: I20100507000043 |
| Provider Name | Cynthia White |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821029133 PECOS PAC ID: 2466580790 Enrollment ID: I20100507000103 |
| Provider Name | Candace T Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619908951 PECOS PAC ID: 5294825386 Enrollment ID: I20100507000657 |
| Provider Name | Martin K Johnson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1174692248 PECOS PAC ID: 7517095755 Enrollment ID: I20100510000594 |
| Provider Name | Marc E Magod |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1467533745 PECOS PAC ID: 9739217829 Enrollment ID: I20100511000622 |
| Provider Name | William R Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447281928 PECOS PAC ID: 3971631938 Enrollment ID: I20100512000471 |
| Provider Name | Karrar Husain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407925696 PECOS PAC ID: 2163550054 Enrollment ID: I20100513000958 |
| Provider Name | John C Hayes |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1073694352 PECOS PAC ID: 1759471840 Enrollment ID: I20100517000744 |
| Provider Name | James L Edwards |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1972684231 PECOS PAC ID: 9032248729 Enrollment ID: I20100518000385 |
| Provider Name | Wendy Mcneill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265512636 PECOS PAC ID: 6002945771 Enrollment ID: I20100519000412 |
| Provider Name | Robert Nevill Gates |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902985237 PECOS PAC ID: 3476643560 Enrollment ID: I20100520000695 |
| Provider Name | Robert K Thacker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306926621 PECOS PAC ID: 5698804524 Enrollment ID: I20100602000318 |
| Provider Name | Charles A Ross |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174603492 PECOS PAC ID: 3971633157 Enrollment ID: I20100615000276 |
| Provider Name | Dominic W Mckinley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518905041 PECOS PAC ID: 1254462732 Enrollment ID: I20100628000215 |
| Provider Name | Lisa L Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962571760 PECOS PAC ID: 2163555087 Enrollment ID: I20100729000331 |
| Provider Name | Michael E Norins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699739557 PECOS PAC ID: 3870626534 Enrollment ID: I20100802000200 |
| Provider Name | Kimberlee Dilda Shaw |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245436203 PECOS PAC ID: 5799801817 Enrollment ID: I20100927000866 |
| Provider Name | Jehanzeb Memon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336371434 PECOS PAC ID: 3173649100 Enrollment ID: I20100928000836 |
| Provider Name | Victoria Rankins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649320284 PECOS PAC ID: 5395861223 Enrollment ID: I20100928000944 |
| Provider Name | Sarah Jane Williams |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1447569181 PECOS PAC ID: 4789878711 Enrollment ID: I20101103000542 |
| Provider Name | Dell Andrew Dembosky |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1639155971 PECOS PAC ID: 6305871153 Enrollment ID: I20101122000782 |
| Provider Name | Margaret A Flynn-cook |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386723260 PECOS PAC ID: 8729277330 Enrollment ID: I20110113000474 |
| Provider Name | Francis Wong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366542631 PECOS PAC ID: 3476651100 Enrollment ID: I20110228000665 |
| Provider Name | Tabatha Jo Berry |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1841509445 PECOS PAC ID: 1052592680 Enrollment ID: I20110302000057 |
| Provider Name | Chad R Rund |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1043482508 PECOS PAC ID: 9032288998 Enrollment ID: I20110520000115 |
| Provider Name | Valerie Mumm Decarlo |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1043516644 PECOS PAC ID: 9537330287 Enrollment ID: I20110929000188 |
| Provider Name | Allen Christian Hill |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487690723 PECOS PAC ID: 2567636871 Enrollment ID: I20111123000426 |
| Provider Name | Jennifer M Wilson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639453285 PECOS PAC ID: 4486828696 Enrollment ID: I20111129000077 |
| Provider Name | Lana Sue O'neal |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1750320727 PECOS PAC ID: 4688626708 Enrollment ID: I20120314000247 |
| Provider Name | Marilee F Runge |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467762062 PECOS PAC ID: 3375708852 Enrollment ID: I20120709000037 |
| Provider Name | Erica Renee Wallace |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528293883 PECOS PAC ID: 7911163332 Enrollment ID: I20120730000205 |
| Provider Name | Kawanta F Durham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821224866 PECOS PAC ID: 7517113244 Enrollment ID: I20120810000538 |
| Provider Name | Baljinder Kumar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578706925 PECOS PAC ID: 5092965251 Enrollment ID: I20121024000192 |
| Provider Name | Thao P Le |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780811448 PECOS PAC ID: 8527219278 Enrollment ID: I20121107000000 |
| Provider Name | Stacey L Brickell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336487479 PECOS PAC ID: 9436304466 Enrollment ID: I20130225000084 |
| Provider Name | William H Tipton |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1538408802 PECOS PAC ID: 3476798588 Enrollment ID: I20130320000431 |
| Provider Name | Sophia Hussain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386962199 PECOS PAC ID: 4082848767 Enrollment ID: I20131011001218 |
| Provider Name | Aaron Morrow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730166794 PECOS PAC ID: 5496777609 Enrollment ID: I20140123002029 |
| Provider Name | Huankai Hu |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1538323563 PECOS PAC ID: 2466617774 Enrollment ID: I20140128001170 |
| Provider Name | Suzanne Nickel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023337714 PECOS PAC ID: 6305960154 Enrollment ID: I20140620001925 |
| Provider Name | Carol Dewan Webb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356667570 PECOS PAC ID: 4385860469 Enrollment ID: I20140725000891 |
| Provider Name | Jennifer Nicole Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013324920 PECOS PAC ID: 5294954558 Enrollment ID: I20140918000682 |
| Provider Name | Roshen Thomas Edathil |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1114327467 PECOS PAC ID: 9234350018 Enrollment ID: I20141020001743 |
| Provider Name | Jennifer Ozan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1154633394 PECOS PAC ID: 1153543145 Enrollment ID: I20141106001083 |
| Provider Name | Kaitlin Aynsley Boos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750785333 PECOS PAC ID: 2769704279 Enrollment ID: I20141210002486 |
| Provider Name | Michael Williams |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265827638 PECOS PAC ID: 9335460211 Enrollment ID: I20150603002364 |
| Provider Name | Michael C Way |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1578767125 PECOS PAC ID: 3971815861 Enrollment ID: I20150707001197 |
| Provider Name | Karen A Schooler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699034983 PECOS PAC ID: 2567683972 Enrollment ID: I20150728005008 |
| Provider Name | Jason Michael Hope |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1720286453 PECOS PAC ID: 1658525779 Enrollment ID: I20160226001253 |
| Provider Name | Courtney S Keatts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073970539 PECOS PAC ID: 5395040364 Enrollment ID: I20160229002837 |
| Provider Name | Beverly A Clark |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1770583924 PECOS PAC ID: 9931001930 Enrollment ID: I20160804000593 |
| Provider Name | Junwei Chen |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1679717953 PECOS PAC ID: 9436370756 Enrollment ID: I20160830000262 |
| Provider Name | Courtney L Archambo |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477884393 PECOS PAC ID: 5698804045 Enrollment ID: I20160907002497 |
| Provider Name | Janine Janine Scott-lowe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487638045 PECOS PAC ID: 8729367966 Enrollment ID: I20161111000268 |
| Provider Name | Clark Alfred Powers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1275697021 PECOS PAC ID: 3072610096 Enrollment ID: I20170222002326 |
| Provider Name | Emily Stone |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1790228278 PECOS PAC ID: 0749564110 Enrollment ID: I20170302000975 |
| Provider Name | Romana Sevcikova Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811435423 PECOS PAC ID: 2668759382 Enrollment ID: I20170508000599 |
| Provider Name | Parag Ashvinkumar Brahmbhatt |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1821394370 PECOS PAC ID: 8123397502 Enrollment ID: I20170628000144 |
| Provider Name | Bhupinder Multani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659829265 PECOS PAC ID: 0648555649 Enrollment ID: I20170707001285 |
| Provider Name | Deema J Farah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669887295 PECOS PAC ID: 4880810191 Enrollment ID: I20170814003338 |
| Provider Name | Arya Karki |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750532156 PECOS PAC ID: 4981820875 Enrollment ID: I20180312002584 |
| Provider Name | Verna L Auge |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255430039 PECOS PAC ID: 7113943168 Enrollment ID: I20180621002141 |
| Provider Name | Samantha Marie Robertson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1023413267 PECOS PAC ID: 4183947252 Enrollment ID: I20180720002790 |
| Provider Name | Yongxin Chen |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1528354883 PECOS PAC ID: 7214239730 Enrollment ID: I20180803002967 |
| Provider Name | Andrew Ronald Brake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174022743 PECOS PAC ID: 5698025096 Enrollment ID: I20180905003845 |
| Provider Name | Natalie Metts Stroud |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003393174 PECOS PAC ID: 2466703913 Enrollment ID: I20180921000882 |
| Provider Name | Jennifer Lynn Campbell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184118952 PECOS PAC ID: 1557613403 Enrollment ID: I20181004001308 |
| Provider Name | Traci Ann Bast |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851956965 PECOS PAC ID: 1456685155 Enrollment ID: I20190701000894 |
| Provider Name | Lori Jane Swanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699116442 PECOS PAC ID: 2365686854 Enrollment ID: I20190729001100 |
| Provider Name | Taye Tolcha Gonfa |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528412483 PECOS PAC ID: 6709114952 Enrollment ID: I20190826002066 |
| Provider Name | Brooke Stoner Greenwood |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497213557 PECOS PAC ID: 5294067138 Enrollment ID: I20191028000297 |
| Provider Name | Shannon Masneri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487727202 PECOS PAC ID: 1456591668 Enrollment ID: I20191028000318 |
| Provider Name | Emilee Smith Barr |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073071908 PECOS PAC ID: 8426481748 Enrollment ID: I20191127000891 |
| Provider Name | Mary Anderson Yonjof |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740827617 PECOS PAC ID: 5890124705 Enrollment ID: I20200327002457 |
| Provider Name | Kathryn Stewart Timberlake |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184155541 PECOS PAC ID: 3779905070 Enrollment ID: I20200615001468 |
| Provider Name | Steven C Cordero |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1821259862 PECOS PAC ID: 9638591829 Enrollment ID: I20200616002496 |
| Provider Name | Stephanie Matthews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083248470 PECOS PAC ID: 1658794623 Enrollment ID: I20200709000399 |
| Provider Name | Amanda Trakas Lawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255954244 PECOS PAC ID: 2860817277 Enrollment ID: I20200803000620 |
| Provider Name | Kyle C Levitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912427923 PECOS PAC ID: 2769753110 Enrollment ID: I20200824002155 |
| Provider Name | Rinka Ravi Pahwani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790201770 PECOS PAC ID: 8820415201 Enrollment ID: I20200831001755 |
| Provider Name | Bevin Renee Strickland |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679031207 PECOS PAC ID: 2062832231 Enrollment ID: I20201009001155 |
| Provider Name | Katelyn Carroll |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063971364 PECOS PAC ID: 6204256050 Enrollment ID: I20201015002026 |
| Provider Name | Melissa Stout Davies |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932636016 PECOS PAC ID: 9931479128 Enrollment ID: I20210720001098 |
| Provider Name | Kyle Andrew Alexander |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1902335912 PECOS PAC ID: 7315216264 Enrollment ID: I20210722003400 |
| Provider Name | Alexandra Josephine Orischak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356005979 PECOS PAC ID: 9739573221 Enrollment ID: I20220226000014 |
| Provider Name | Jessica Marie Easley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639821010 PECOS PAC ID: 4688053127 Enrollment ID: I20220614001275 |
| Provider Name | Eli Hammer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730641556 PECOS PAC ID: 6305173683 Enrollment ID: I20220715001398 |
| Provider Name | Stacy Stahl |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962177352 PECOS PAC ID: 0547653131 Enrollment ID: I20220725001204 |
| Provider Name | Sneha Penmetsha Raju |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316409030 PECOS PAC ID: 0648651455 Enrollment ID: I20220725002126 |
| Provider Name | Jonathan Austin Henderson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720646920 PECOS PAC ID: 4880076223 Enrollment ID: I20220802002832 |
| Provider Name | Kathryn Drea-cullen Doermann |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1649990102 PECOS PAC ID: 0941685465 Enrollment ID: I20220920002789 |
| Provider Name | Brooke Michelle Hester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851028393 PECOS PAC ID: 5799161246 Enrollment ID: I20221006000937 |
| Provider Name | Hannah Kontoulas Stamey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922747310 PECOS PAC ID: 8022494467 Enrollment ID: I20221007001914 |
| Provider Name | Lisa Paula Rudd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629700349 PECOS PAC ID: 2163899345 Enrollment ID: I20221031002749 |
| Provider Name | Sarah Trimble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083925770 PECOS PAC ID: 4981874799 Enrollment ID: I20230613000768 |
| Provider Name | Taylar Patricia Pridgen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023715539 PECOS PAC ID: 3476913260 Enrollment ID: I20230712000403 |
| Provider Name | Ryan Lee Welborn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942829965 PECOS PAC ID: 5294195756 Enrollment ID: I20230714002808 |
| Provider Name | Claire M Vreeland |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1639699499 PECOS PAC ID: 5395017883 Enrollment ID: I20230825002237 |
| Provider Name | Neil Schwartzman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295806750 PECOS PAC ID: 4688582026 Enrollment ID: I20230905002821 |
| Provider Name | Evan Madden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487181210 PECOS PAC ID: 3870858228 Enrollment ID: I20231107001842 |
Greensboro True Health Chiropractic, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 530 N Elam Ave Ste C, Greensboro, NC 27403 Phone: 336-866-0340 | |
3ehome Visiting Provider Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7614 Cedar Chase Dr, Greensboro, NC 27455 Phone: 702-328-1646 | |
Guilford Medical Center, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1593 Yanceyville St, Suite 100, Bldg A, Greensboro, NC 27405 Phone: 336-275-1306 Fax: 336-275-1307 | |
Eagle Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5500 W Friendly Ave Ste 200, Greensboro, NC 27410 Phone: 336-373-1996 Fax: 336-482-2320 | |
Infocus Eyewear Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 719 Green Valley Rd, Ste 303 B, Greensboro, NC 27408 Phone: 336-235-2577 Fax: 336-235-2578 | |
Cone Health Sickle Cell Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 509-e North Elam Avenue, 3rd Floor, Greensboro, NC 27403 Phone: 336-832-1970 Fax: 336-832-1988 | |
Viarenew Greensboro, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5587 Garden Village Way, Ste E, Greensboro, NC 27410 Phone: 336-763-1600 Fax: 336-763-6796 |