NPIMap

Organization Active NPI

Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
National Provider Identifier
1003803032
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
WAKE FOREST UNIVERSITY HEALTH SCIENCES
Practice address
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone
(336) 716-2255
NPI assigned
Oct 4, 2005
Last updated
Jul 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Authorized official

Name
Dr. David William Zaas, MDNPI 1588748461
Title
President, Ah WFB
Phone
(336) 713-4944

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-0001

Mailing address

PO Box 344
Winston Salem, NC 27102-0344
Phone (336) 716-2255

Other practice location 1

4614 Country Club Rd
Winston Salem, NC 27104-3520
Phone (336) 716-2255

Other practice location 2

3903 N Elm St
Greensboro, NC 27455-2877
Phone (336) 716-2255

Other identifiers 4

IdentifierTypeStateIssuer
2433646OtherNCMCARE GROUP NUMBER - PODI
89013KWMedicaidNC
07001OtherNCBCBS
C08811OtherVAMCARE GROUP - VIRGINIA ME

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark, LLC.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA, FL, GA, OH, MA, HI, UT, TX, NV, MI, WA, CA, KS, OR, CO, IL, NY, AZ20 enrollments

Enrollment records 20

Enrollment IDStateProvider typePAC IDDetails
O20031105000436 NC Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 3,530 practitioners
9 other NPIs on this enrollment
O20040930000434 VA Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 2 practitioners
Practice locations: Leesburg, VA; Middleburg, VA
O20100930071484 NC DME Supplier - Multi-Specialty - PhysicianDME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 4486564952 Practice locations: Winston Salem, NC
O20260220000404 FL Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 8 practitioners
Practice locations: Beverly Hills, FL; Wellington, FL; Sarasota, FL; Santa Rosa Beach, FL; Palm City, FL; Melbourne Beach, FL; Highland Beach, FL; Fort Lauderdale, FL
O20260221000929 GA Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 2 practitioners
Practice locations: Clayton, GA; Macon, GA
O20260223003165 OH Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 2 practitioners
Practice locations: Westlake, OH; New Albany, OH
O20260224000738 MA Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 1 practitioner
Practice locations: Lexington, MA
O20260303001595 HI Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI
O20260303001734 UT Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 1 practitioner
Practice locations: St George, UT
O20260303003379 TX Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 3 practitioners
Practice locations: Dripping Springs, TX; Houston, TX; Spicewood, TX
O20260305000279 NV Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 1 practitioner
Practice locations: Reno, NV
O20260305002484 MI Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 2 practitioners
Practice locations: Ann Arbor, MI; West Bloomfield, MI
O20260305003483 WA Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 3 practitioners
Practice locations: Bellevue, WA; Lake Forest Park, WA; Liberty Lake, WA
O20260311002985 CA Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 4 practitioners
Practice locations: Corona del Mar, CA; Huntington Beach, CA; Rancho Cucamonga, CA; San Diego, CA
O20260311003608 KS Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 3 practitioners
Practice locations: Hays, KS; Topeka, KS; Lawrence, KS
O20260323000221 OR Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 1 practitioner
Practice locations: La Grande, OR
O20260327001209 CO Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 7 practitioners
Practice locations: Colorado Springs, CO; Denver, CO; Grand Junction, CO; Monument, CO; Pagosa Springs, CO; Parker, CO
O20260402003955 IL Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 1 practitioner
Practice locations: Oak Brook, IL
O20260514000051 NY Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 1 practitioner
Practice locations: Sag Harbor, NY
O20260519002035 AZ Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 3 practitioners
Practice locations: Chandler, AZ; Cave Creek, AZ; Scottsdale, AZ

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations (25 of 161)

541 Main St
Ste 130
Weymouth, MA 02190

329 NC Highway 801 N
#2
Advance, NC 27006

223 W Ward St
#B
Asheboro, NC 27203

223 W Ward St
Ste 100
Asheboro, NC 27203
Phone (336) 333-6443

223 W Ward St
Ste 102
Asheboro, NC 27203
Phone (336) 625-3338

50 Doctors Dr
#120W
Asheville, NC 28801

108 Dornach Way
Bermuda Run, NC 27006
Phone (336) 940-2407

419 Twins Way
Bermuda Run, NC 27006
Phone (336) 716-8091

2311 Lewisville Clemmons Rd
#3
Clemmons, NC 27012

2311 Lewisville Clemmons Rd
Fl 3
Clemmons, NC 27012
Phone (336) 713-8900

2341 Lewisville Clemmons Rd
Clemmons, NC 27012
Phone (336) 713-2121

2341 Lewisville Clemmons Rd
Fl 2
Clemmons, NC 27012
Phone (336) 716-4039

2419 Lewisville Clemmons Rd
Clemmons, NC 27012

3417 Graystone Pl SE
Conover, NC 28613

180 Parkwood Dr
#Z
Elkin, NC 28621

300 Johnson Ridge Medical Park
Elkin, NC 28621
Phone (336) 258-8094

401 Eldon Parks Dr
Elkin, NC 28621
Phone (336) 835-9589

1016 N Elm St
Greensboro, NC 27401
Phone (336) 272-6153

1331 N Elm St
Ste 100
Greensboro, NC 27401
Phone (336) 618-0397

200 E Northwood St
Greensboro, NC 27401
Phone (336) 275-6115

2005 Pisgah Church Rd
Ste 100
Greensboro, NC 27455

2014 Pisgah Church Rd
Greensboro, NC 27455

3120 Northline Ave
Ste 101
Greensboro, NC 27408
Phone (336) 765-5722

3120 Northline Ave
Ste 102
Greensboro, NC 27408
Phone (336) 716-1957

3132 Battleground Ave
Greensboro, NC 27408
Phone (336) 545-3132

Practitioners & affiliated clinicians

Practitioners 4,159

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 4,159

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1003803032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 344",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271020344",
            "telephone_number": "336-716-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4614 Country Club Rd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271043520",
            "country_code": "US",
            "telephone_number": "336-716-2255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3903 N Elm St",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274552877",
            "country_code": "US",
            "telephone_number": "336-716-2255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WAKE FOREST UNIVERSITY HEALTH SCIENCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "ZAAS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT, AH WFB",
        "authorized_official_telephone_number": "336-713-4944",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE GROUP NUMBER - PODI",
            "identifier": "2433646",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89013KW",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "07001",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE GROUP - VIRGINIA ME",
            "identifier": "C08811",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.1",
            "affiliationName": "Bluemark, LLC.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "40 Sunset Ridge Rd Ste 120",
            "city": "New Paltz",
            "state": "NY",
            "country_code": "US",
            "postal_code": "125611039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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 Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.