Organization Active NPI

Family Care of Winston-Salem, PA

  • Family Medicine Physician
  • Winston-Salem, NC
National Provider Identifier
1073565727
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY CARE OF WINSTON-SALEM, PA
Practice address
1365 Westgate Center Dr
Ste C1
Winston-Salem, NC 27103-2980
Phone
(336) 768-6682
Fax
(336) 768-8212
NPI assigned
May 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Eldon S Beard, MD
Title
President
Phone
(336) 768-6682

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1365 Westgate Center Dr
Ste C1
Winston-Salem, NC 27103-2980

Mailing address

1365 Westgate Center Dr
Ste C1
Winston-Salem, NC 27103-2980
Phone (336) 768-6682

National Provider Directory

National Provider Directory

Locations

1365 Westgate Center Dr
Ste C1
Winston Salem, NC 27103
Phone (336) 768-6682

5519 Gumtree Rd
Ste 200
Winston Salem, NC 27107

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17109/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073565727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 WESTGATE CENTER DR",
            "address_2": "STE C1",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271032980",
            "telephone_number": "336-768-6682",
            "fax_number": "336-768-8212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 WESTGATE CENTER DR",
            "address_2": "STE C1",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271032980",
            "telephone_number": "336-768-6682",
            "fax_number": "336-768-8212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE OF WINSTON-SALEM, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEARD",
        "authorized_official_first_name": "ELDON",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-768-6682",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 22, 2020; 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.