IMMANUEL FAMILY PRACTICE
NPI 1164487823
Clinic/Center - Medical Specialty in Greensboro, NC
About Immanuel Family Practice NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IMMANUEL FAMILY PRACTICE (NPI 1164487823) is a healthcare organization registered as a medical specialty in Greensboro, North Carolina and active in the NPI registry since April 2006. The organization holds a CLIA Waiver certificate valid through October 5, 2028 and lists Betti D Reese, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Immanuel Family Practice is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Immanuel Family Practice, which bills Medicare for the services this clinician delivers.
Clinician (1)
Greensboro, NC 27410
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 34D1031665
Immanuel Family Practice · Greensboro, NCFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Immanuel Family Practice's NPI number?
The NPI number for Immanuel Family Practice is 1164487823. It was assigned to this organization in the NPPES registry on April 18, 2006.
Where is Immanuel Family Practice located?
Immanuel Family Practice is located at 5500 W Friendly Ave Suite 201, Greensboro, NC 27410. The listed phone number is (336) 856-9996.
What is Immanuel Family Practice's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.
Is Immanuel Family Practice enrolled in Medicare?
Yes. Immanuel Family Practice is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Immanuel Family Practice?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Immanuel Family Practice. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Immanuel Family Practice hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 34D1031665) is associated with this NPI, valid through October 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Immanuel Family Practice was last updated on December 10, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Immanuel Family Practice · NPI 1164487823
Medical Specialty organization in Greensboro, North Carolina. Organization record, active in the CMS NPPES registry since April 18, 2006.
## Identity
- **NPI:** 1164487823 (Entity type: Organization)
- **Enumerated:** April 18, 2006
- **Primary specialty:** Clinic/Center - Medical Specialty · taxonomy 261QM2500X
- **Organization subpart:** No
- **Authorized official:** Betti Reese, PRESIDENT
## Practice location
- **Address:** 5500 W FRIENDLY AVE, SUITE 201, Greensboro, NC 27410-4212
- **Phone:** (336) 856-9996
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 10, 2007
- **Other identifiers:** Medicare PIN 2340461 (NC); Medicaid 89016JV (NC)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1164487823) · Data from the CMS NPPES public registry.