Genesis Medical Practice, PLLC
NPI 1205662004ActiveOrganization· Internal Medicine· Greensboro, NC
Internal Medicine in Greensboro, North Carolina, registered in NPPES in September 2024. The authorized official on file is Brian Shackleford, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1205662004 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 10, 2024 |
| Last updated in NPPES | Sep 10, 2024 |
| Certified by provider | Sep 10, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NC) |
|---|
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