Provider Demographics
NPI:1740214436
Name:PIEDMONT MEDICAL ASSOCIATES PA
Entity Type:Organization
Organization Name:PIEDMONT MEDICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSIAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARR
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:919-875-8150
Mailing Address - Street 1:3500 BUSH ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7509
Mailing Address - Country:US
Mailing Address - Phone:919-875-8150
Mailing Address - Fax:919-875-9577
Practice Address - Street 1:3500 BUSH ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7509
Practice Address - Country:US
Practice Address - Phone:919-875-8150
Practice Address - Fax:919-875-9577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2173656Medicare ID - Type UnspecifiedJOSIAH CARR II MD
NC7902424Medicaid
NC8921399Medicaid
2599415BMedicare ID - Type UnspecifiedJOAN BRITT FNP
0481Medicare ID - Type UnspecifiedMEDICARE GROUP
NC02424OtherBCBS NC GROUP