NPIMap

Organization Active NPI

McCorkle Laboratory Enterprise LLC

  • Clinic/Center
  • Winston Salem, NC
National Provider Identifier
1003576018
Registry record updated Dec 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MCCORKLE LABORATORY ENTERPRISE LLC
Doing business as
McCorkle Laboratory Enterprise LLC
Practice address
500 W 5TH St Ste 800
Winston Salem, NC 27101-3131
Phone
(336) 800-5227
NPI assigned
Dec 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2021

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

Authorized official

Name
Ms. Tyria McCorkle
Title
Ceo
Phone
(336) 800-5227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

500 W 5TH St Ste 800
Winston Salem, NC 27101-3131

Mailing address

500 W 5TH St Ste 800
Winston Salem, NC 27101-3131
Phone (336) 800-5227

Other names 1

  • McCorkle Laboratory Enterprise LLC Doing business as

National Provider Directory

National Provider Directory

Locations

500 W 5th St
Ste 800
Winston Salem, NC 27101
Phone (336) 247-1068

NPI Registry JSON

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

{
    "created_epoch": "1639872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639872000000",
    "number": "1003576018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W 5TH ST STE 800",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013131",
            "telephone_number": "336-800-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W 5TH ST STE 800",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013131",
            "telephone_number": "336-800-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCORKLE LABORATORY ENTERPRISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-19",
        "last_updated": "2021-12-19",
        "certification_date": "2021-12-19",
        "status": "A",
        "authorized_official_last_name": "MCCORKLE",
        "authorized_official_first_name": "TYRIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-800-5227",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McCorkle Laboratory Enterprise LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.