Organization Active NPI

Fifth River Mental Health

  • Psychiatry Physician
  • Winston Salem, NC
National Provider Identifier
1083911820
Registry record updated Feb 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
FIFTH RIVER MENTAL HEALTH
Practice address
755 Highland Oaks Dr
Suite 202
Winston Salem, NC 27103-7106
Phone
(336) 608-4060
Fax
(336) 665-8188
NPI assigned
Feb 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2011

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

Authorized official

Name
Dr. Gisela E Knebl Kohl, MDNPI 1922217306
Title
President
Phone
(954) 558-3608

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0800X NC Primary

Addresses

Primary practice location

755 Highland Oaks Dr
Suite 202
Winston Salem, NC 27103-7106

Mailing address

1112 Oakencroft CT
Lewisville, NC 27023-8727
Phone (336) 608-4060

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1297641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297641600000",
    "number": "1083911820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 OAKENCROFT CT",
            "city": "LEWISVILLE",
            "state": "NC",
            "postal_code": "270238727",
            "telephone_number": "336-608-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 HIGHLAND OAKS DR",
            "address_2": "SUITE 202",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271037106",
            "telephone_number": "336-608-4060",
            "fax_number": "336-665-8188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIFTH RIVER MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-14",
        "last_updated": "2011-02-14",
        "status": "A",
        "authorized_official_last_name": "KNEBL KOHL",
        "authorized_official_first_name": "GISELA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-558-3608",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "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 Feb 14, 2011; 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.