Basic Information
Provider Information
NPI: 1386772036
EntityType: 2
ReplacementNPI:  
OrganizationName: CORNERSTONE HEALTH CARE LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: ASHEBORO FOOT AND ANKLE SPECIALISTS
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1701 WESTCHESTER DRIVE
Address2: SUITE 850
City: HIGH POINT
State: NC
PostalCode: 272627254
CountryCode: US
TelephoneNumber: 3368022536
FaxNumber: 3368022534
Practice Location
Address1: 225 W WARD ST
Address2:  
City: ASHEBORO
State: NC
PostalCode: 272035423
CountryCode: US
TelephoneNumber: 3366253338
FaxNumber: 3366251563
Other Information
ProviderEnumerationDate: 03/02/2007
LastUpdateDate: 05/27/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HILL
AuthorizedOfficialFirstName: ANNE
AuthorizedOfficialMiddleName: C
AuthorizedOfficialTitleorPosition: BUSINESS SERVICES OFFICER
AuthorizedOfficialTelephone: 3368022400
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
213E00000X42NCY193400000X SINGLE SPECIALTY GROUPPodiatric Medicine & Surgery Service ProvidersPodiatrist 

ID Information
IDTypeStateIssuerDescription
5013901NCMEDCOSTOTHER
D26601NCPARTNERSOTHER
012ME01NCBCBSOTHER
715977801NCAETNAOTHER
CD661401NCRR MEDICAREOTHER
CC424101NCRR MEDICAREOTHER
CC424301NCRR MEDICAREOTHER
89012MF05NC MEDICAID
121266002501NCDMEOTHER
CB865801NCRR MEDICAREOTHER


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