Active NPI
Piedmont Gastroenterology Specialists, PA
- Gastroenterology Physician
- Winston Salem, NC
National Provider Identifier
1083715023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- Legal business name
- PIEDMONT GASTROENTEROLOGY SPECIALISTS, PA
- Practice address
- 1901 S Hawthorne Rd
Suite 310
Winston Salem, NC 27103-3921 - Phone
- (336) 760-4340
- Fax
- (336) 765-2869
- NPI assigned
- Sep 25, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Michelle L Wallace, CMPE
- Title
- Practice Administrator
- Phone
- (336) 714-3544
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | Primary |
Addresses
Primary practice location
1901 S Hawthorne Rd
Suite 310
Winston Salem, NC 27103-3921
Mailing address
1901 S Hawthorne Rd
Suite 310
Winston Salem, NC 27103-3921
Phone (336) 760-4340
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8901548 | Medicaid | NC |
National Provider Directory
National Provider DirectoryLocations
1901 S Hawthorne Rd
Ste 310
Winston Salem, NC 27103
Phone (336) 448-2427
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gastroenterology Physician
- Winston Salem, NC
- NPI 1558328492
-
- Gastroenterology Physician
- Winston Salem, NC
- NPI 1306803234
-
- Gastroenterology Physician
- Winston Salem, NC
- NPI 1568429405
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1350000000000",
"number": "1083715023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1901 S HAWTHORNE RD",
"address_2": "SUITE 310",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271033921",
"telephone_number": "336-760-4340",
"fax_number": "336-765-2869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 S HAWTHORNE RD",
"address_2": "SUITE 310",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271033921",
"telephone_number": "336-760-4340",
"fax_number": "336-765-2869"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PIEDMONT GASTROENTEROLOGY SPECIALISTS, PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-25",
"last_updated": "2012-10-12",
"status": "A",
"authorized_official_last_name": "WALLACE",
"authorized_official_first_name": "MICHELLE",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
"authorized_official_telephone_number": "336-714-3544",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "CMPE"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8901548",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winston Salem, NC
- Piedmont Endoscopy Center, Inc.
- Piedmont Family & Occupational Medicine Urgent Care PLLC
- Piedmont Family Healthcare
- Piedmont Family Medicine, Occupational Health and Urgent Care, LLC
- Piedmont Foot and Ankle Associates PC
- Piedmont Hem Onc Associates
- Piedmont Hematology-Oncology Associates, PLLC
- Piedmont Homehealth, Inc.
- Piedmont Imaging LLC (Novant Health Imaging Piedmont)
- Piedmont Imaging LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.