MEDICARE: MOSES CONE AFFILIATED PHYSICIANS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	213ES0131X	Foot Surgery Podiatrist
2	213E00000X	Podiatrist
3	213EP1101X	Primary Podiatric Medicine Podiatrist
4	213ES0103X	Foot & Ankle Surgery Podiatrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	023K0	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1952614620
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOSES CONE AFFILIATED PHYSICIANS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 745032
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-5032
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 N CHURCH ST
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27405-5633
Country	:	US
Telephone Number	:	336-375-6990
Fax Number	:	336-375-0361

Authorized Official
Title or Position	:	DIRECTOR, OPERATIONS
Name	:	JARED COOPER
Credential	:
Telephone Number	:	336-663-5044

Provider Enumeration Date	:	07/22/2010
Last Update Date	:	02/21/2025

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Directions to “MOSES CONE AFFILIATED PHYSICIANS, INC. ” Practice Location

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