Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Genesis Medical Practice, PLLC

Organization Internal Medicine Physician · NPI 1205662004

Genesis Medical Practice, PLLC is an Internal Medicine Physician in Greensboro, North Carolina. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1921 New Garden Rd
Greensboro, NC 27410-2193
Phone: (919) 370-8188
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X

Record details

NPI number1205662004
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brian Shackleford — Owner · (919) 370-8188
NPI enumeratedSeptember 10, 2024
Last updated in NPPESSeptember 10, 2024
Certification dateSeptember 10, 2024
Mailing address1921 New Garden Rd Apt I104, Greensboro, NC 27410-2200

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