Active NPI
Wake Forest Health Network LLC
- Family Medicine Physician
- Winston Salem, NC
National Provider Identifier
1023142122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- WAKE FOREST HEALTH NETWORK LLC
- Practice address
- 1665 Westbrook Plaza Dr
Winston Salem, NC 27103-2993 - Phone
- (336) 760-8380
- Fax
- (336) 760-8388
- NPI assigned
- Mar 14, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Craig Michael Greven, MD
- Title
- Sr VP Clinical Operations
- Phone
- (336) 716-1331
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
1665 Westbrook Plaza Dr
Winston Salem, NC 27103-2993
Mailing address
1665 Westbrook Plaza Dr
Winston Salem, NC 27103-2993
Phone (336) 760-8380
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CC4242 | Other | NC | RAILROAD MEDICARE |
| 5905774 | Medicaid | NC | |
| CC5472 | Other | NC | RAILROAD MEDICARE |
| D266 | Other | NC | PARTNERS MEDICARE CHOICE |
| 98096 | Other | MEDCOST | |
| CB8658 | Other | NC | RAILROAD MEDICARE |
| CC6608 | Other | NC | RAILROAD MEDICARE |
| 0007312143 | Other | AETNA | |
| 018PH | Other | NC | BCBS |
| 269374 | Other | MAMSI | |
| CC4243 | Other | NC | RAILROAD MEDICARE |
| CD6614 | Other | NC | RAILROAD MEDICARE |
| CF9200 | Other | NC | RAILROAD MEDICARE |
| CC4241 | Other | NC | RAILROAD MEDICARE |
Other names 1
- Atrium Health Wake Forest Baptist Family Medicine - Westbrook Plaza
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D0977842 | Ahwfb Family Medicine Westbrook Plaza | Certificate of waiver | May 9, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nurse Practitioner
- Winston Salem, NC
- NPI 1134298052
-
- Nurse Practitioner
- Winston Salem, NC
- NPI 1902400443
-
- Family Medicine Physician
- Winston Salem, NC
- NPI 1619472511
-
- Physician Assistant
- Knoxville, TN
- NPI 1912949975
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1758758400000",
"number": "1023142122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1665 WESTBROOK PLAZA DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271032993",
"telephone_number": "336-760-8380",
"fax_number": "336-760-8388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1665 WESTBROOK PLAZA DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271032993",
"telephone_number": "336-760-8380",
"fax_number": "336-760-8388"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WAKE FOREST HEALTH NETWORK LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-14",
"last_updated": "2025-09-25",
"certification_date": "2025-09-25",
"status": "A",
"authorized_official_last_name": "GREVEN",
"authorized_official_first_name": "CRAIG",
"authorized_official_middle_name": "MICHAEL",
"authorized_official_title_or_position": "SR VP CLINICAL OPERATIONS",
"authorized_official_telephone_number": "336-716-1331",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CC4242",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5905774",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CC5472",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS MEDICARE CHOICE",
"identifier": "D266",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "98096",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CB8658",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CC6608",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0007312143",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "018PH",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "269374",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CC4243",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CD6614",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CF9200",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CC4241",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "Ability Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "64 S Price Rd Ste B",
"city": "Brownsville",
"state": "TX",
"country_code": "US",
"postal_code": "785212459",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Atrium Health Wake Forest Baptist Family Medicine - Westbrook Plaza",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Winston Salem, NC
- Wake Forest Baptist Imaging, LLC
- Wake Forest Baptist Medical Center
- Wake Forest Baptist Medical Center
- Wake Forest Baptist Medical Center
- Wake Forest Baptist Medical Center Community Physicians
- Wake Forest Health Network LLC
- Wake Forest Health Network LLC
- Wake Forest Health Network LLC
- Wake Forest Health Network LLC
- Wake Forest Health Network LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.