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PINE HAVEN FAMILY MEDICINE PA
NPI 1891960241
Family Medicine in Randleman, NC

Active since April 28, 2008CLIA 34D1041720 · Waiver
604 WEST ACADEMY ST, RANDLEMAN, NC 27317(336) 498-1200(336) 498-1206 Get Directions Write a Review

NPPES record last updated: November 30, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Pine Haven Family Medicine Pa NPPES

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

PINE HAVEN FAMILY MEDICINE PA (NPI 1891960241) is a healthcare organization registered as a family medicine in Randleman, North Carolina and active in the NPI registry since April 2008. The organization holds a CLIA Waiver certificate valid through January 30, 2027 and lists John James Slatosky, Owner Physician, as its authorized official.

NPPES Registry Identity

NPI1891960241
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePINE HAVEN FAMILY MEDICINE PA
Location Address604 WEST ACADEMY STRandleman, NC 27317
Mailing Address604 West Academy StRandleman, NC 27317 · (336) 498-1200 · Fax (336) 498-1206
Phone(336) 498-1200
Fax(336) 498-1206
Organization SubpartNo
Authorized OfficialJohn James SlatoskyOwner Physician · (336) 498-1200
Enumeration DateApril 28, 2008
Last NPPES UpdateNovember 30, 2012
✔ NPI 1891960241 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NC · 9900682
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
604 WEST ACADEMY ST, Randleman, NC 27317
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Other Identifiers 4

Other2348546NC · Medicare
Medicare PIN2400880D
Medicare UPINH02774
Medicaid891212UNC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 34D1041720

Pine Haven Family Medicine PA · Randleman, NC
Active · expires Jan 30, 2027
CLIA Number34D1041720
Laboratory TypePhysician Office
Certificate Effective DateJanuary 31, 2025
Certificate Expiration DateJanuary 30, 2027
Laboratory DirectorJohn J. Slatosky
Laboratory Phone(336) 498-1200
Laboratory LocationPine Haven Family Medicine PA604 West Academy St, Randleman, NC 27317
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently 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 Pine Haven Family Medicine PA's NPI number?

The NPI number for Pine Haven Family Medicine PA is 1891960241. It was assigned to this organization in the NPPES registry on April 28, 2008.

Where is Pine Haven Family Medicine PA located?

Pine Haven Family Medicine PA is located at 604 West Academy St, Randleman, NC 27317. The listed phone number is (336) 498-1200.

What is Pine Haven Family Medicine PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Pine Haven Family Medicine PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D1041720) is associated with this NPI, valid through January 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pine Haven Family Medicine PA was last updated on November 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.