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STEP UP PEDIATRIC AND ADOLESCENT WELLNESS CENTER NPI 1801163423


NPI Information

NPI: 1801163423
Provider Name: STEP UP PEDIATRIC AND ADOLESCENT WELLNESS CENTER
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
3410 HEALY DR
SUITE 110
WINSTON SALEM, NC
ZIP 27103
Phone: (336) 765-8614
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STEP UP PEDIATRIC AND ADOLESCENT WELLNESS CENTER 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. STEP UP PEDIATRIC AND ADOLESCENT WELLNESS CENTER NPI is 1801163423. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3410 HEALY DR
SUITE 110
WINSTON SALEM, NC
ZIP 27103-403
Phone: (336) 765-8614
Fax: (336) 765-8605

The provider's authorized official is Leticia Estela Helleby-hardy .
The authorized official title is Director and has the following contact phone number (336) 765-8614.

The enumeration date for this NPI number is 11/28/2011 and was last updated on 4/26/2016.


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
1101YP2500XCounselorProfessionalNORTH CAROLINANo
2363LF0000XNurse PractitionerFamily124938NORTH CAROLINANo
3208000000XPediatrics177279NORTH 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
1F469MEDICARE PINNORTH CAROLINA
2026MPOTHERBCBS

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: 11/14/2023

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