Individual provider Active NPI

David Allen Duncan, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Winston-Salem, NC
National Provider Identifier
1124004122
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
35324 Issued in NC
Practice address
4622 Country Club Rd
Suite 180
Winston-Salem, NC 27104-3770
Phone
(336) 768-9535
Fax
(336) 768-4155
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 35324 NC Primary

Addresses

Primary practice location

4622 Country Club Rd
Suite 180
Winston-Salem, NC 27104-3770

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 768-9535

Other identifiers 1

IdentifierTypeStateIssuer
8929389MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dduncan27448@direct.novanthealth.org

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100823000849 NC Practitioner - Thoracic Surgery 6406924422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
University of Florida College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

4622 Country Club Rd
Suite 180
Winston Salem, NC 27104-3770
Phone (336) 768-9535

Hospital & facility affiliations

  • Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014
  • Twin County Regional Hospital Hospital, Galax, VA, CCN 490115

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35324NCMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Jul 1, 2012 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 1, 2012 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

330 Billingsley Rd
Ste 202
Charlotte, NC 28211
Phone (704) 316-2350

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

4622 Country Club Rd
Ste 180
Winston Salem, NC 27104
Phone (336) 768-9535

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

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.

Hospital & facility affiliations 3

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": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1124004122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-768-9535",
            "fax_number": "336-768-4155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4622 COUNTRY CLUB RD",
            "address_2": "SUITE 180",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271043770",
            "telephone_number": "336-768-9535",
            "fax_number": "336-768-4155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2020-10-28",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NC",
            "license": "35324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8929389",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dduncan27448@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "4622 Country Club Rd",
            "address_2": "Suite 180",
            "city": "Winston-Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271043770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston-Salem, NC

Sources for this page

Verify at the official NPI Registry.