Individual provider Active NPI

William Tyler Cecil, D.O.

  • Psychiatry Physician
  • Winston Salem, NC
National Provider Identifier
1003279779
Registry record updated Aug 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2021-01923 Issued in NC
Practice address
Department of Psychiatry
791 Jonestown Road
Winston Salem, NC 27103-1252
Phone
(336) 716-4551
Fax
(336) 716-9642
NPI assigned
Mar 31, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2021-01923 NC Primary

Addresses

Primary practice location

Department of Psychiatry
791 Jonestown Road
Winston Salem, NC 27103-1252

Mailing address

Wake Forest School of Medicine
Dept of Psychiatry, Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-4551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210720000961 NC Practitioner - Psychiatry 9537452917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

791 Jonestown Rd
WFBH Psychiatry Jonestown
Winston-Salem, NC 27103-1252
Phone (336) 716-2255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jul 26, 2021 Accepting new patients

Locations

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

791 Jonestown Rd
Winston Salem, NC 27103

Interoperability endpoints

  • Direct secure messaging: wcecil2755179@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628380800000",
    "number": "1003279779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WAKE FOREST SCHOOL OF MEDICINE",
            "address_2": "DEPT OF PSYCHIATRY, MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-4551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF PSYCHIATRY",
            "address_2": "791 JONESTOWN ROAD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031252",
            "telephone_number": "336-716-4551",
            "fax_number": "336-716-9642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CECIL",
        "first_name": "WILLIAM",
        "middle_name": "TYLER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-31",
        "last_updated": "2021-08-08",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2021-01923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.