| Select Specialty Hospital - Greensboro Inc. | |
|
1200 N Elm St 5th Floor Greensboro NC 27401-1004 | |
| (336) 832-5700 | |
| (336) 832-5750 |
| Full Name | Select Specialty Hospital - Greensboro Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1200 N Elm St, Greensboro, North Carolina |
| Authorized Official Name and Position | Michael Tarvin (VICE PRESIDENT) |
| Authorized Official Contact | 7179721100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Select Specialty Hospital - Greensboro Inc. 4714 Gettysburg Rd Legal Department Mechanicsburg PA 17055-4325 Ph: (717) 972-1100 | Select Specialty Hospital - Greensboro Inc. 1200 N Elm St 5th Floor Greensboro NC 27401-1004 Ph: (336) 832-5700 |
| NPI Number | 1912205113 |
|---|---|
| Provider Enumeration Date | 03/11/2011 |
| Last Update Date | 05/24/2011 |
| Medicare PECOS PAC ID | 7810049335 |
|---|---|
| Medicare Enrollment ID | O20101223000116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912205113 | NPI | - | NPPES |
| 2348059 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ronnie L Jacobs |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205898483 PECOS PAC ID: 9032000336 Enrollment ID: I20040324001006 |
| Provider Name | Stephanie D Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952350241 PECOS PAC ID: 5799750394 Enrollment ID: I20040827000529 |
| Provider Name | Charles Kanayo Agunobi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609864446 PECOS PAC ID: 0749220440 Enrollment ID: I20050711000131 |
| Provider Name | Ndofunsu Mabeka Badika |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114915758 PECOS PAC ID: 8426067687 Enrollment ID: I20060417000323 |
| Provider Name | Harmeet Singh |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1306866967 PECOS PAC ID: 6406944479 Enrollment ID: I20071109000080 |
| Provider Name | Munsoor N Lateef |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1073716742 PECOS PAC ID: 7517023401 Enrollment ID: I20090302000044 |
| Provider Name | Adeel M Siddiqui |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609812338 PECOS PAC ID: 5890852818 Enrollment ID: I20090318000684 |
| Provider Name | Ali A Hijazi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1225033368 PECOS PAC ID: 3476656174 Enrollment ID: I20121109000477 |
| Provider Name | Umar Bowers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841511136 PECOS PAC ID: 5991948788 Enrollment ID: I20130827000016 |
| Provider Name | Anupama Matcha |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033341565 PECOS PAC ID: 0840427514 Enrollment ID: I20131230001612 |
| Provider Name | Belinda Kyeiwah Kyere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235550054 PECOS PAC ID: 9638309909 Enrollment ID: I20140306000460 |
| Provider Name | Chun Xiang Li |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295152601 PECOS PAC ID: 5294958633 Enrollment ID: I20140603001573 |
| Provider Name | Harriet Hodgkin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912097080 PECOS PAC ID: 1658443288 Enrollment ID: I20150224000802 |
| Provider Name | Stephanie Chin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720459407 PECOS PAC ID: 7517268659 Enrollment ID: I20151215002067 |
| Provider Name | Patrick Twum-barimah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003253931 PECOS PAC ID: 6709178940 Enrollment ID: I20160831002141 |
| Provider Name | Mukesh Kumar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144566712 PECOS PAC ID: 4880828391 Enrollment ID: I20170620000774 |
| Provider Name | Kingsley Prakash Anand Pudota |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942594924 PECOS PAC ID: 6103078993 Enrollment ID: I20170728003160 |
| Provider Name | Zohayr M Al-shaial |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841245537 PECOS PAC ID: 0143269928 Enrollment ID: I20170807000384 |
| Provider Name | Priya Varghese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184111866 PECOS PAC ID: 6608125497 Enrollment ID: I20180828002674 |
| Provider Name | Se Hyang Han |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669016556 PECOS PAC ID: 2567883812 Enrollment ID: I20200522001089 |
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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 | |
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