SHALOM PEDIATRIC CLINIC (NPI# 1316227739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316227739 |
| Entity Type | Organization |
| Organization Name | SHALOM PEDIATRIC CLINIC |
| Practice Address |
2806 Randleman Rd Suite M Greensboro NC 27406-5265 |
| Practice Telephone | 3365748355 |
| Practice Fax Number | 3362739192 |
| Mailing Telephone | 3365748355 |
| Mailing Fax Number | 3362739192 |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2011-08-17 |
| Authorized Official Name | DR. RITA OBIAGELI NNAEMEKAOKOYEH (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3365748355 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
2005-01548 | NC | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 4188 | 05 |
| Street Address |
2806 RANDLEMAN RD SUITE M |
| City | GREENSBORO |
| State | NC |
| Zip Code | 27406-5265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548750201 | Lesia Ann Lancaster | Counselor | 1451 South Elm-eugene Street, Suite 3109, Greensboro, NC 27406 | 2018-05-17 |
| 1538667092 | Brittany T. Price | Specialist/Technologist | 5806 Davis Mill Rd., Greensboro, NC 27406 | 2018-01-30 |
| 1457868168 | Therapyworks Counseling, Pllc | Clinic/Center | 1451 S Elm Eugene St Unit 54, Greensboro, NC 27406 | 2018-01-03 |
| 1548776644 | Brent Douglas Sprinkle | Counselor | 1451 S Elm Eugene St # 3107, Greensboro, NC 27406 | 2017-12-27 |
| 1922537216 | Liam Buckley | Specialist/Technologist | 201 Mcadoo Avenue, Apt 3f, Greensboro, NC 27406 | 2017-06-08 |
| 1669903589 | Reba Siler Kennedy | Specialist | 1325 South Eugene Street, Suite 102, Greensboro, NC 27406 | 2017-03-22 |
| 1811433089 | Lee Street Services LLC | Community/Behavioral Health | 1202 East Mountain St, Unit C, Kernersville, NC 27406 | 2017-01-12 |
| 1811430184 | A & A Health Care Agency, Inc. | Custodial Care Facility | 2600 Kilpatrick-white Rd, Greensboro, NC 27406 | 2016-11-18 |
| 1063877900 | Yolanda Deonne Ector | Rehabilitation Practitioner | 5605 Country Club Rd, Greensboro, NC 27406 | 2015-12-18 |
| 1053785121 | Mamie Turner | Behavioral Analyst | 5202 Olde Forest Dr, Greensboro, NC 27406 | 2015-11-30 |
| Find all providers in zip 27406 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194233403 | Futuremed Evening Clinic Pllc | Clinic/Center | 2003 Boulevard St Ste C, Greensboro, NC 27407-4579 | 2018-01-21 |
| 1285865329 | Wayland W Mckenzie Md Pa | Clinic/Center | 500 Banner Ave Ste A, Greensboro, NC 27401-3284 | 2009-08-06 |
| 1154540078 | William Ray Mcginty Jr. | Clinic/Center | 1060 Greshams Ft, Greensboro, GA 30642-4888 | 2007-04-25 |
| 1235273509 | Wayland Wilson Mckenzie | Clinic/Center | 500 A Banner Ave, Greensboro, NC 27401-3284 | 2007-02-19 |
| 1871522003 | General Medical Clinic, Pa | Clinic/Center | 3710w Gate City Blvd, Greensboro, NC 27407-4646 | 2006-07-01 |
| 1306884069 | United Youth Care Services | Clinic/Center | 1207 4th Street, Greensboro, NC 27405 | 2006-06-03 |
| 1033766092 | Osh-mi Physicians Group PC | Clinic/Center | 1007 Summit Ave, Greensboro, NC 27405-7007 | 2019-08-23 |
| 1730625518 | Cone Center for Children | Clinic/Center | 301 E Wendover Ave, Suite 400, Greensboro, NC 27401-1230 | 2017-01-17 |
| 1851744627 | Moses Cone Medical Services, Inc. | Clinic/Center | 1581 Yanceyville St, Greensboro, NC 27405-6958 | 2016-07-18 |
| 1881054922 | Serenity Rehabilitation Services | Clinic/Center | 2216 W Meadowview Rd, Greensboro, NC 27407-3406 | 2016-03-02 |
| Find all providers in GREENSBORO | ||||
| City | GREENSBORO |
| Zip Code | 27406 |
Please comment or provide details below to improve the information on SHALOM PEDIATRIC CLINIC.
| 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.