NPIMap

Individual provider Active NPI

Aaron Wooten, PT, PA-C

  • Surgical Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1104135706
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0010-09188 Issued in NC
Practice address
131 Miller St
Winston Salem, NC 27103-2508
Phone
(336) 716-8091
NPI assigned
Sep 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P12724 NC
Surgical Physician Assistant 363AS0400X 0010-09188 NC Primary

Addresses

Primary practice location

131 Miller St
Winston Salem, NC 27103-2508

Mailing address

4601 Park Rd Ste 300
Charlotte, NC 28209-2290
Phone (704) 323-2248

Other practice location 1

170 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone (336) 768-1270

Other identifiers 1

IdentifierTypeStateIssuer
12724OtherNCNC LICESNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200224000019 NC Practitioner - Physician Assistant 6103095088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Brody School of Medicine at East Carolina University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest University Health Sciences 2,633 clinicians

Practice addresses (Care Compare)

1901 Mooney St
Winston Salem, NC 27103-3027
Phone (336) 716-8091

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-09188NCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences Physical Therapist CurrentSince Dec 25, 2019 Accepting new patients
North Carolina Baptist Hospital Past Accepting new patients

Locations

2341 Lewisville Clemmons Rd
Fl 2
Clemmons, NC 27012
Phone (336) 716-4039

1901 Mooney St
Winston Salem, NC 27103
Phone (336) 716-8091

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

131 Miller St
Winston Salem, NC 27103
Phone (336) 716-4161

Interoperability endpoints

  • Direct secure messaging: awooten2755551@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1104135706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092290",
            "telephone_number": "704-323-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 MILLER ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032508",
            "telephone_number": "336-716-8091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 Kimel Park Dr",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271036946",
            "country_code": "US",
            "telephone_number": "336-768-1270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOTEN",
        "first_name": "AARON",
        "credential": "PT, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-29",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P12724",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-09188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC LICESNE",
            "identifier": "12724",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.