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  7. NPI Record 1144288085

PRIME CARE OF HICKORY BRANCH
Complete NPI Record 1144288085
Emergency Medicine in Greensboro, NC

NPI Status: Active since May 02, 2006

Contact Information

501 HICKORY BRANCH DR
DBA PRIMECARE HICKORY BRANCH
GREENSBORO, NC
ZIP 27409
Phone: (336) 878-2260
Fax: (336) 878-2277

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider Other Organization Name
  6. Provider Other Organization Name Type Code
  7. Provider First Line Business Mailing Address
  8. Provider Second Line Business Mailing Address
  9. Provider Business Mailing Address City Name
  10. Provider Business Mailing Address State Name
  11. Provider Business Mailing Address Postal Code
  12. Provider Business Mailing Address Country Code If outside U S
  13. Provider Business Mailing Address Telephone Number
  14. Provider Business Mailing Address Fax Number
  15. Provider First Line Business Practice Location Address
  16. Provider Second Line Business Practice Location Address
  17. Provider Business Practice Location Address City Name
  18. Provider Business Practice Location Address State Name
  19. Provider Business Practice Location Address Postal Code
  20. Provider Business Practice Location Address Country Code If outside U S
  21. Provider Business Practice Location Address Telephone Number
  22. Provider Business Practice Location Address Fax Number
  23. Provider Enumeration Date
  24. Last Update Date
  25. Authorized Official Last Name
  26. Authorized Official First Name
  27. Authorized Official Middle Name
  28. Authorized Official Title or Position
  29. Authorized Official Telephone Number
  30. Healthcare Provider Taxonomy Code 1
  31. Healthcare Provider Primary Taxonomy Switch 1
  32. Healthcare Provider Taxonomy Code 2
  33. Healthcare Provider Primary Taxonomy Switch 2
  34. Healthcare Provider Taxonomy Code 3
  35. Healthcare Provider Primary Taxonomy Switch 3
  36. Healthcare Provider Taxonomy Code 4
  37. Healthcare Provider Primary Taxonomy Switch 4
  38. Is Organization Subpart
  39. Healthcare Provider Taxonomy Group 1
  40. Healthcare Provider Taxonomy Group 2
  41. Healthcare Provider Taxonomy Group 3
  42. Healthcare Provider Taxonomy Group 4

Complete NPI Dataset

This page represents the complete record for NPI 1144288085. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1144288085
Entity Type Code: 2
Employer Identification Number EIN: UNAVAIL
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization Name: PRIME CARE OF HICKORY BRANCH
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code: 3
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: 2000 FRONTIS PLAZA BLVD STE 200
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Second Line Business Mailing Address: (ATTN) FORSYTH MEDICAL GROUP
The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address City Name: WINSTON SALEM
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: NC
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 271035616
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 3362772435
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 3362779275
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 501 HICKORY BRANCH DR
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address: DBA PRIMECARE HICKORY BRANCH
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: GREENSBORO
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: NC
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 274099601
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 3368782260
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 3368782277
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 5/2/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 8/22/2020
The date that a record was last updated or changed.
Authorized Official Last Name: BARRY
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: PAUL
The first name of the authorized official.
Authorized Official Middle Name: M.
The middle name of the authorized official.
Authorized Official Title or Position: MEDICAL DIRECTOR
The title or position of the authorized official.
Authorized Official Telephone Number: 3367740040
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 207P00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: X
Healthcare Provider Taxonomy Code 2: 207Q00000X
Healthcare Provider Primary Taxonomy Switch 2: X
Healthcare Provider Taxonomy Code 3: 363A00000X
Healthcare Provider Primary Taxonomy Switch 3: X
Healthcare Provider Taxonomy Code 4: 363L00000X
Healthcare Provider Primary Taxonomy Switch 4: X
Is Organization Subpart: N
Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 2: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 3: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 4: 193200000X MULTI-SPECIALTY GROUP