PREMIER PEDIATRICS OF EDEN
NPI 1114228475
Pediatrics in Eden, NC

Q: What is Moses Cone Affiliated Physicians, Inc.'s specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Active since November 03, 2010CLIA 34D2015283 · Waiver

509 S VAN BUREN RD, SUITE B, EDEN, NC 27288(336) 627-5437(336) 627-1681 Get Directions Write a Review

NPPES record last updated: November 29, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Premier Pediatrics Of Eden NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PREMIER PEDIATRICS OF EDEN (NPI 1114228475) is a healthcare organization registered as a pediatrics in Eden, North Carolina and active in the NPI registry since November 2010. The organization holds a CLIA Waiver certificate valid through October 24, 2026 and lists Kenneth K Boggs, Cfo/treasurer, as its authorized official.

NPPES Registry Identity

NPI1114228475

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameMOSES CONE AFFILIATED PHYSICIANS, INC.

Location Address509 S VAN BUREN RD, SUITE BEden, NC 27288-5082

Mailing Address509 S Van Buren Rd, Suite BEden, NC 27288-5082 · (336) 627-5437 · Fax (336) 627-1681

Phone(336) 627-5437

Fax(336) 627-1681

Organization SubpartYesParent: The Moses H. Cone Memorial Hospital

Authorized OfficialKenneth K BoggsCfo/treasurer · (336) 832-8005

Enumeration DateNovember 3, 2010

Last NPPES UpdateNovember 29, 2012

✔ NPI 1114228475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

509 S VAN BUREN RD, Eden, NC 27288

Open in Google Maps ↗

Other Names 1

Doing Business AsPremier Pediatrics Of Eden

Other Identifiers 1

Medicaid5916799NC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Blue Cross and Blue Shield of NC.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2015283

Premier Pediatrics Of Eden · Eden, NC

Active · expires Oct 24, 2026

CLIA Number34D2015283

Laboratory TypePhysician Office

Certificate Effective DateOctober 25, 2024

Certificate Expiration DateOctober 24, 2026

Laboratory DirectorVivian D. Salvador

Laboratory Phone(336) 627-5437

Laboratory LocationPremier Pediatrics Of Eden509 South Van Buren Road, Suite B, Eden, NC 27288

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ZAINAB S QAYUMI M.D

Pediatrics

509 S VAN BUREN RD, SUITE B
EDEN, NC 27288

Rockingham County (336) 627-5437

LAYNE'S FAMILY PHARMACY, INC.

Durable Medical Equipment & Medical Supplies