Organization · NPI-2
Bethany Medical Center
Nurse Practitioner · Mount Airy, NC
NPI number1528525839
StatusActive
Last updated in NPPESJun 24, 2026
Details
- NPI
- 1528525839
- Entity type
- Organization (NPI-2)
- Legal business name
- Bethany Medical Center
- Organization subpart
- No
- Enumeration date
- Feb 22, 2019
- Certification date
- Jun 24, 2026
- Last updated
- Jun 24, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | – | – | Yes |
| 207N00000X | Dermatology | – | – | |
| 363LF0000X | Nurse Practitioner, Family | – | – | |
| 207Q00000X | Family Medicine | – | – | |
| 208VP0000X | – | – | ||
| 207R00000X | Internal Medicine | – | – | |
| 363A00000X | Physician Assistant | – | – |
Practice location
1908 Caudle Dr Ste 105Mount Airy, NC 27030-4322
Phone 336-883-0029 · Fax 336-883-0867
Mailing address
645 N Main StHigh Point, NC 27260-5017
Phone 369-670-8463 · Fax 336-899-2176
Authorized official
Lenin J Peters
Ceo
3368830029
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