BETHANY MEDICAL CENTER (NPI# 1992133870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992133870 |
| Entity Type | Organization |
| Organization Name | BETHANY MEDICAL CENTER |
| Other Organization Name | BETHANY PATHOLOGY LAB |
| Practice Address |
100 N Bridge St Suite C Wilkesboro NC 28697-2488 |
| Mailing Address |
507 N Lindsay St High Point NC 27262-4303 |
| Practice Telephone | 3368830029 |
| Practice Fax Number | 3368992188 |
| Mailing Telephone | 3368830029 |
| Mailing Fax Number | 3368992188 |
| Enumeration Date | 2013-10-31 |
| Last Update Date | 2013-10-31 |
| Authorized Official Name | MANDY WOMBLE (CFO) |
| Authorized Official Telephone | 3368830029 |
| Is Organization Subpart | Y |
| Parent Organization Name | BETHANY MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZC0500X |
Pathology Specialization: Cytopathology |
NC | Allopathic & Osteopathic Physicians | |
| N | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
NC | Allopathic & Osteopathic Physicians | |
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5907644 | 05 | |
| NC | 89011F1 | 05 | |
| NC | 7901101 | 05 | |
| NC | 3409940 | 05 |
| Other Name | Type Code |
|---|---|
| Bethany Pathology Lab | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861049231 | Bethany Medical Center | Internal Medicine | 975 Hwy 66 S, Kernersville, NC 27284 | 2019-08-21 |
| 1508341736 | Bethany Medical Center | Anesthesiology | 190 Independence Ave Ste B, North Wilkesboro, NC 28659-4270 | 2018-10-03 |
| 1467829663 | Bethany Medical Center | Clinical Medical Laboratory | 575 N Patterson Ave, Suite 440, Winston Salem, NC 27101-4101 | 2015-08-24 |
| 1972065282 | Bethany Medical Center | Dermatology | 410 College Rd, Greensboro, NC 27410-5151 | 2019-04-04 |
| 1508328816 | Bethany Medical Center | Dermatology | 4002 Spring Garden St, Greensboro, NC 27407-1683 | 2019-04-04 |
| 1528525839 | Bethany Medical Center | Dermatology | 1908 Caudle Dr Ste 100, Mount Airy, NC 27030-4322 | 2019-02-22 |
| 1003382839 | Bethany Medical Center | Dermatology | 3801 W Market St, Greensboro, NC 27407-1301 | 2018-10-19 |
| 1710453550 | Bethany Medical Center | Anesthesiology | 5093 University Pkwy, Winston Salem, NC 27106-6085 | 2018-10-19 |
| 1528554631 | Bethany Medical Center | Pain Medicine | 160 Kimel Forest Dr Ste 100, Winston Salem, NC 27103-6084 | 2018-07-02 |
| 1255880571 | Bethany Medical Center | Internal Medicine | 1580 Skeet Club Rd, High Point, NC 27265-9005 | 2016-09-28 |
| Street Address |
100 N BRIDGE ST SUITE C |
| City | WILKESBORO |
| State | NC |
| Zip Code | 28697-2488 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346679206 | Aci Support Specialists | Day Training, Developmentally Disabled Services | 330 Darnell Lane, Wilkesboro, NC 28697 | 2013-11-01 |
| 1639456676 | Strategic Interventions | Community/Behavioral Health | 176 Rest Home Road, Wilkesboro, NC 28697 | 2011-11-04 |
| 1063703247 | Tessa Walter | Physical Therapist | 371 Old Farms Road, Wilkesboro, NC 28697 | 2011-04-22 |
| 1922242742 | Pradip Thakkar, Md | Family Medicine | 1600 Curtis Bridge Road, Wilkesboro, NC 28697 | 2009-04-23 |
| 1366656746 | Khot Medical Clinic | Family Medicine | 1216 D School St, Wilkesboro, NC 28697 | 2007-05-09 |
| 1295868644 | Amy K. Gardner | Marriage & Family Therapist | 507 Courthouse Drive, Wilkesboro, NC 28697 | 2007-03-14 |
| 1457405854 | Appalachian Counseling | Counselor | 100 North Bridge St, Suite 101, Wilkesboro, NC 28697 | 2007-01-22 |
| 1194893818 | Thomas K Mcmahan Md Pa | Internal Medicine | 1710 Parkwood Drive, Wilkesboro, NC 28697 | 2006-12-01 |
| 1952480246 | Walter Clyde Holloway | Chiropractor | 1240 School Street, Wilkesboro, NC 28697 | 2006-11-06 |
| 1609958750 | Wal-mart Stores East, Lp | Eyewear Supplier (Equipment, not the service) | 1801 Us Hwy 421, Wilkesboro, NC 28697 | 2006-10-19 |
| Find all providers in zip 28697 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508484965 | Azad Bakht | Pathology | Medical Center Boulevard Department of Pathology, Winston Salem, NC 27157-0001 | 2020-07-10 |
| 1316401375 | Celligent Diagnostics, LLC | Pathology | 101 E W T Harris Blvd Ste 1212, Charlotte, NC 28262-3423 | 2019-01-24 |
| 1487170387 | Coastal Carolina Pathology, Pa | Pathology | 2606 Iron Gate Dr Ste 201, Wilmington, NC 28412-2494 | 2017-08-22 |
| 1134651748 | Elsa Mondou | Pathology | 6008 Bunchberry Ct, Raleigh, NC 27616-5454 | 2017-04-02 |
| 1578910006 | Jennifer Michelle Crimmins | Pathology | Dumc 3712, Durham, NC 27710-4220 | 2016-05-13 |
| 1407237811 | Cori Breslauer | Pathology | Pathology and Lab Medicine, Bbb Cb 7525, Chapel Hill, NC 27599-7525 | 2015-06-11 |
| 1548668338 | Cheryl Levine | Pathology | 1740 Montclair Ave, Gastonia, NC 28054-4848 | 2014-12-11 |
| 1396005369 | Bart B Singer | Pathology | Unc Pathology Cb 7525 Brinkhous-bullitt Building, Chapel Hill, NC 27599-7525 | 2012-05-23 |
| 1750670279 | Nathan Samuel Cuka | Pathology | 3333 Silas Creek Pkwy Fl 1, Winston Salem, NC 27103-3013 | 2011-04-05 |
| 1669790994 | Sara Elizabeth Wobker | Pathology | 303 Brinkhouse Bullitt Bldg, Department of Pathology, Cb# 7525, Chapel Hill, NC 27599-7525 | 2010-05-11 |
| Find all providers with the same taxonomy | ||||
| City | WILKESBORO |
| Zip Code | 28697 |
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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.