Active NPI
Maria-Dorina Cruz Sevilla, M.D.
- Geriatric Medicine (Internal Medicine) Physician
- Winston Salem, NC
National Provider Identifier
1114991098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- 9300588
- Practice address
- 4692 Brownsboro Rd
Winston Salem, NC 27106-3410 - Phone
- (336) 251-1114
- Fax
- (336) 251-1115
- NPI assigned
- Feb 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 9300588 | NC | Primary |
Addresses
Primary practice location
4692 Brownsboro Rd
Winston Salem, NC 27106-3410
Mailing address
4692 Brownsboro Rd
Winston Salem, NC 27106-3410
Phone (336) 251-1114
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8975331 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9300588 | NC | MD | Geriatric Medicine (Internal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297123200000",
"number": "1114991098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4692 BROWNSBORO RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271063410",
"telephone_number": "336-251-1114",
"fax_number": "336-251-1115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4692 BROWNSBORO RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271063410",
"telephone_number": "336-251-1114",
"fax_number": "336-251-1115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEVILLA",
"first_name": "MARIA-DORINA",
"middle_name": "CRUZ",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-15",
"last_updated": "2011-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "NC",
"license": "9300588",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8975331",
"state": "NC"
}
],
"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 8, 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.