NPIMap

Organization Active NPI

D R Bland MD PA

  • Gynecology Physician
  • Winston Salem, NC
National Provider Identifier
1003895889
Registry record updated Jan 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
36315 Issued in NC
Legal business name
D R BLAND MD PA
Practice address
201 Executive Park Blvd
Winston Salem, NC 27103-1503
Phone
(336) 774-9000
NPI assigned
Jan 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2008

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

Authorized official

Name
Dr. Deirdre Robinson Bland, MD
Title
President
Phone
(336) 774-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X 36315 NC Primary

Addresses

Primary practice location

201 Executive Park Blvd
Winston Salem, NC 27103-1503

Mailing address

201 Executive Park Blvd
Winston Salem, NC 27103-1503
Phone (336) 774-9000

Other identifiers 2

IdentifierTypeStateIssuer
36315OtherNCNC STATE LICENSE
2329864OtherNCMEDICARE GROUP #

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201046400000",
    "number": "1003895889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 EXECUTIVE PARK BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031503",
            "telephone_number": "336-774-9000",
            "fax_number": "336-774-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 EXECUTIVE PARK BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031503",
            "telephone_number": "336-774-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D R BLAND MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2008-01-23",
        "status": "A",
        "authorized_official_last_name": "BLAND",
        "authorized_official_first_name": "DEIRDRE",
        "authorized_official_middle_name": "ROBINSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-774-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NC",
            "license": "36315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC STATE LICENSE",
            "identifier": "36315",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "2329864",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "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 Jan 23, 2008; 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.