1689673279 NPI number — PIEDMONT NEPHROLOGY & HYPERTENSION ASSOCIATES, PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689673279 NPI number — PIEDMONT NEPHROLOGY & HYPERTENSION ASSOCIATES, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PIEDMONT NEPHROLOGY & HYPERTENSION ASSOCIATES, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689673279
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/11/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1899 TATE BLVD SE
Provider Second Line Business Mailing Address:
SUITE 2101
Provider Business Mailing Address City Name:
HICKORY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28602-4200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-327-7788
Provider Business Mailing Address Fax Number:
828-327-0112

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1899 TATE BLVD SE
Provider Second Line Business Practice Location Address:
SUITE 2101
Provider Business Practice Location Address City Name:
HICKORY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28602-4200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-327-7788
Provider Business Practice Location Address Fax Number:
828-327-0112
Provider Enumeration Date:
07/18/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WEAVER
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
828-327-7788

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  32718 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)