FORSYTH MEDICAL GROUP LLC (NPI# 1205191418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205191418 |
| Entity Type | Organization |
| Organization Name | FORSYTH MEDICAL GROUP LLC |
| Other Organization Name | NOVANT HEALTH CARDIOLOGY ELKIN |
| Practice Address |
189 Samaritans Ridge Rd Elkin NC 28621-2472 |
| Mailing Address |
Po Box 751803 Charlotte NC 28275-1803 |
| Practice Telephone | 3365263005 |
| Practice Fax Number | 3365263011 |
| Mailing Telephone | 3365263005 |
| Mailing Fax Number | 3365263011 |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2019-02-02 |
| Authorized Official Name | GEOFFREY K GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043847680 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1205191418 | 05 |
| Other Name | Type Code |
|---|---|
| Novant Health Cardiology Elkin | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 Johnson Ridge Medical Park, Elkin, NC 286212400 | 3365263005 | 3365263011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902332406 | Forsyth Medical Group LLC | Pediatrics | 1471 Jag Branch Rd, Suite 101, Kernersville, NC 27284-6956 | 2017-05-04 |
| 1245244094 | Forsyth Medical Group LLC | Physician Assistant | 2000 Frontis Plaza Blvd Ste 2000, Winston Salem, NC 27103-5616 | 2006-07-28 |
| 1013430107 | Forsyth Medical Group LLC | Pediatrics | 648 E Monmouth St, Winston Salem, NC 27107-3227 | 2017-07-20 |
| 1003078999 | Forsyth Medical Group LLC | Pediatrics | 2821 Maplewood Ave, Winston Salem, NC 27103-4137 | 2008-07-01 |
| 1255542742 | Forsyth Medical Group LLC | Urology | 180 Kimel Park Dr Ste 110, Winston Salem, NC 27103-6970 | 2007-05-25 |
| 1285682310 | Forsyth Medical Group LLC | Physician Assistant | 216 Moore Rd, King, NC 27021-8703 | 2006-05-04 |
| 1528016516 | Forsyth Medical Group LLC | Physician Assistant | Robinhood Medical Plaza, Bldg 200, Winston-salem, NC 27106 | 2006-05-04 |
| 1114985017 | Forsyth Medical Group LLC | Physician Assistant | 240 Broad St, Kernersville, NC 27284-2930 | 2006-05-02 |
| 1073571881 | Forsyth Medical Group LLC | Physician Assistant | 2001 Todays Woman Ave, Winston-salem, NC 27105-5069 | 2006-05-02 |
| Street Address |
189 SAMARITANS RIDGE RD |
| City | ELKIN |
| State | NC |
| Zip Code | 28621-2472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003828716 | Philip James Iuliano | Internal Medicine | 189 Samaritans Ridge Rd, Elkin, NC 28621-2472 | 2006-08-12 |
| 1801033840 | Kirsten Nielsen | Counselor | 189 Samaritans Ridge Rd, Elkin, NC 28621-2452 | 2009-01-13 |
| 1710167051 | Carol K. Pulley | Psychologist | 189 Samaritans Ridge Rd, Elkin, NC 28621-2472 | 2007-11-04 |
| 1548455298 | Brad Alen Bushong | Chiropractor | 189 Samaritans Ridge Rd, Elkin, NC 28621-2452 | 2007-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013553692 | Carenet, Inc. | Counselor | 1288 C.b. Eller School Road, Elkin, NC 28621 | 2019-11-19 |
| 1386104776 | North Bridge Physio and Sports Performance | Clinic/Center | 1605 North Bridge Street, Elkin, NC 28621 | 2019-03-21 |
| 1609389238 | Rebecca Anne Dumas | Physical Therapist | 145 Valleybrook Dr, Elkin, NC 28621 | 2017-11-06 |
| 1922547744 | Lori Barker | Clinical Nurse Specialist | 124, Samaritan's Ridge Road, Elkin, NC 28621 | 2017-02-13 |
| 1205061256 | Hugh Chatham Memorial Hospital, Inc | Internal Medicine | 520 Chatham Medical Park, Elkin, NC 28621 | 2009-05-20 |
| 1093909236 | Elkin Obstetrics and Gynecology, Pllc | Obstetrics & Gynecology | 101 A Eldon Parks Dr., Elkin, NC 28621 | 2007-08-30 |
| 1497956205 | Nayana Abrol | Internal Medicine | 180 Parkwood Drive, Hugh Chatham Memorial Hospital, Elkin, NC 28621 | 2007-05-30 |
| 1104950765 | Dgis Elkin Inc Dba Chatham Nursing and Rehabilitation | Skilled Nursing Facility | 700 Johnson Ridge Road, Elkin, NC 28621 | 2007-03-15 |
| 1093860777 | Carolina Select Home Care, LLC. | Home Health | 948-b Johnson Ridge Rd., Elkin, NC 28621 | 2007-01-24 |
| 1922160761 | Piedmont Department of Urology, Pllc | Urology | 350 Johnson Ridge Medical Park, Elkin, NC 28621 | 2006-12-15 |
| Find all providers in zip 28621 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003828716 | Philip James Iuliano | Internal Medicine | 189 Samaritans Ridge Rd, Elkin, NC 28621-2472 | 2006-08-12 |
| 1710966718 | David J Bohle | Internal Medicine | 100 Johnson Ridge Medical Park, Elkin, NC 28621-2400 | 2006-01-10 |
| 1740285824 | Tomas Vybiral | Internal Medicine | 640 Parkwood Medical Park, Elkin, NC 28621-2487 | 2005-06-16 |
| 1174759344 | Bt Heart and Vascular Center, Pllc | Internal Medicine | 124 Samaritans Ridge Rd, Elkin, NC 28621-2452 | 2009-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124657663 | Cardiosleep Diagnostics | Internal Medicine | 1862 Old Fort Rd, Greenville, NC 27834-9373 | 2020-04-06 |
| 1619467529 | Clerio Francisco De Azevedo Filho | Internal Medicine | 10 Medicine Circle - Duke Medical Pavilion Room 1e50, Durham, NC 27710-0001 | 2018-05-16 |
| 1700385846 | The Presbyterian Hospital | Internal Medicine | 1918 Randolph Rd Ste 820, Charlotte, NC 28207-1119 | 2018-02-05 |
| 1841713187 | Wake Specialty Physicians LLC | Internal Medicine | 3000 New Bern Ave Ste 1200, Raleigh, NC 27610-1231 | 2017-07-19 |
| 1225563463 | Benjamin Mcginty Chilcutt | Internal Medicine | 300 Meadowmont Village Cir Ste 104, Chapel Hill, NC 27517-7518 | 2017-04-25 |
| 1437517182 | Regional Physicians LLC | Internal Medicine | 103 W Center St, Lexington, NC 27292 | 2016-02-09 |
| 1982069928 | Four Jewels Healthways | Internal Medicine | 320 Lillington Ave Ste 201, Charlotte, NC 28204-3189 | 2015-12-17 |
| 1932505294 | Donald Frederick Fortin | Internal Medicine | 14001 Weston Pkwy, Suite 101, Cary, NC 27513-2255 | 2014-11-14 |
| 1538564232 | Forsyth Memorial Hospital, Inc | Internal Medicine | 694 Riverside Drive, Mt. Airy, NC 27030-3117 | 2014-10-24 |
| 1710382411 | Forsyth Memorial Hospital, Inc | Internal Medicine | 7114 Villiage Medical Circle, Clemmons, NC 27012 | 2014-10-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.