Active NPI
Stacy Wentworth, MD
- Radiation Oncology Physician
- Greensboro, NC
National Provider Identifier
1073792974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- 200700580
- Practice address
- 501 N. Elam Avenue
Greensboro, NC 27403 - Phone
- (336) 832-1100
- NPI assigned
- Oct 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | 2007-00580 | NC | |
| Radiation Oncology Physician | 2085R0001X | 200700580 | NC | Primary |
Addresses
Primary practice location
501 N. Elam Avenue
Greensboro, NC 27403
Mailing address
1317 N Elm St
Ste. 1B
Greensboro, NC 27401-1033
Phone (336) 274-9617
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073792974 | Medicaid | VA | |
| P00838358 | Other | NC | MEDICARE RAILROAD |
| 5912234 | Medicaid | NC |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Radiation Oncology
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
20 Duke Medicine Cir
Durham, NC 27710-2000
Phone (919) 684-8111
Hospital & facility affiliations
- Duke University Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2007-00580 | NC | MD | Radiation Oncology Physician |
| 200700580 | NC | MD | Radiation Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greensboro Radiation Oncologists PA | Radiation Oncology | Current | Accepting new patients |
| Southeast Radiation Oncology Group, P.a. | Radiation Oncology | Current | Accepting new patients |
| Duke Health Integrated Practice, Inc. | Current | Accepting new patients | |
| Greensboro Radiation Oncologist, PA | Past | Accepting new patients |
Locations
200 Queens Rd
Ste 400
Charlotte, NC 28204
Phone (704) 765-2578
20 Duke Medicine Cir
Durham, NC 27710
Phone (919) 668-6608
40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588
2400 W Friendly Ave
Greensboro, NC 27403
Phone (336) 832-1100
3404 Wake Forest Rd
Raleigh, NC 27609
Phone (919) 862-5400
Interoperability endpoints
- swentworth604693@direct.medicine.duke.edu
- swentworth566067@directhisp.wakemed.org
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- Durham, NC
- NPI 1205553369
-
- Radiation Oncology Physician
- Greensboro, NC
- NPI 1609828698
-
- Radiation Oncology Physician
- Charlotte, NC
- NPI 1568400109
-
- Specialist
- Greensboro, NC
- NPI 1417186297
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- Raleigh, NC
- NPI 1205225646
-
- Rehabilitation Hospital Unit
- Durham, NC
- NPI 1538166061
-
- General Acute Care Hospital
- Durham, NC
- NPI 1992703540
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344556800000",
"number": "1073792974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1317 N ELM ST",
"address_2": "STE. 1B",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274011033",
"telephone_number": "336-274-9617",
"fax_number": "336-482-2177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 N. ELAM AVENUE",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "27403",
"telephone_number": "336-832-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENTWORTH",
"first_name": "STACY",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-10-26",
"last_updated": "2012-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "NC",
"license": "2007-00580",
"primary": false
},
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "NC",
"license": "200700580",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1073792974",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00838358",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5912234",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.