NPIMap

Organization Active NPI

Forsyth Memorial Hospital Inc

Doing business as Novant Health Forsyth Family Medicine

  • Family Medicine Physician
  • Winston Salem, NC
National Provider Identifier
1033488358
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FORSYTH MEMORIAL HOSPITAL INC
Doing business as
Novant Health Forsyth Family Medicine
Practice address
400 Jonestown Rd
Winston Salem, NC 27104-4623
Phone
(336) 769-9515
Fax
(336) 768-9082
NPI assigned
Dec 15, 2011
Last updated
Jul 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

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 1

  • Novant Health Forsyth Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

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

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1323907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1033488358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "704-384-7603",
            "fax_number": "704-417-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 JONESTOWN RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271044623",
            "telephone_number": "336-769-9515",
            "fax_number": "336-768-9082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORSYTH MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-15",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "LEEA",
        "authorized_official_middle_name": "JEANINE",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "704-316-6081"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Forsyth Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Forsyth Family Medicine",
            "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 Jul 10, 2023; 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.