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WAKE FOREST BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS NPI 1326031543


NPI Information

NPI: 1326031543
Provider Name: WAKE FOREST BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS

Doing Business As: WINSTON EAST PEDIATRICS

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 34D2164202

Address:
2295 EAST 14TH ST
STE 100
WINSTON SALEM, NC
ZIP 27105
Phone: (336) 725-0514
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WAKE FOREST BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS is a pediatrics in Winston Salem, NC. The provider is 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. WAKE FOREST BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS NPI is 1326031543. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Winston East Pediatrics.

The provider's business location address is:

2295 EAST 14TH ST
STE 100
WINSTON SALEM, NC
ZIP 27105
Phone: (336) 725-0514
Fax: (336) 725-2173

The provider's authorized official is Lewis S Thorp .
The authorized official title is President/ceo and has the following contact phone number (336) 721-3900.

The CLIA number assigned to this NPI record is 34D2164202 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/23/2005 and was last updated on 4/10/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsNORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12317728IOTHERNORTH CAROLINAMEDICARE GROUP NUMBER
2890228UMEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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