Forsyth Memorial Hospital Inc

Organization Active NPI Family Medicine Physician · Winston Salem, NC

NPI 1033488358 · NPPES record last updated Jul 10, 2023

Key facts

NPI
1033488358
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
FORSYTH MEMORIAL HOSPITAL INC
Practice address
400 Jonestown Rd
Winston Salem, NC 27104-4623
Phone
(336) 769-9515
Fax
(336) 768-9082
NPI assigned
Dec 15, 2011
Organization subpart
No

Authorized official

Name
Leea Jeanine Walton
Title
RCS Manager
Phone
(704) 316-6081

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040405001702 NC Part B Supplier - Clinic/Group Practice 9537071790 Receives reassigned benefits from 1,329 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

400 Jonestown Rd
Winston Salem, NC 27104-4623

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (704) 384-7603

Other names

  • Novant Health Forsyth Family Medicine Doing business as

Other providers in Winston Salem, NC

All providers in Winston Salem, NC · Family Medicine Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.