Individual provider Active NPI

Victor Wilson Sears, MD

  • Gastroenterology Physician
  • Winston Salem, NC
National Provider Identifier
1053355008
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
36037 Issued in NC
Practice address
2025 Frontis Plaza Blvd
Suite 200
Winston-Salem, NC 27103-5663
Phone
(336) 768-6211
Fax
(336) 768-6869
NPI assigned
Jun 16, 2006
Last updated
Sep 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 36037 NC Primary

Addresses

Primary practice location

2025 Frontis Plaza Blvd
Suite 200
Winston-Salem, NC 27103-5663

Mailing address

2025 Frontis Plaza Blvd
Suite 200
Winston-Salem, NC 27103-5663
Phone (336) 768-6211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060306000638 NC Practitioner - GastroenterologyPractitioner - Internal Medicine 7517973159

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18789NCMDMental Health Counselor
36037NCMDGastroenterology Physician

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1053355008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 FRONTIS PLAZA BLVD",
            "address_2": "SUITE 200",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271035663",
            "telephone_number": "336-768-6211",
            "fax_number": "336-768-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 FRONTIS PLAZA BLVD",
            "address_2": "SUITE 200",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271035663",
            "telephone_number": "336-768-6211",
            "fax_number": "336-768-6869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEARS",
        "first_name": "VICTOR",
        "middle_name": "WILSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "36037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.