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Organization Active NPI

Orthopaedic Specialists of the Carolinas, P.a.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Winston Salem, NC
National Provider Identifier
1124070115
Registry record updated Apr 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
ORTHOPAEDIC SPECIALISTS OF THE CAROLINAS, P.A.
Practice address
170 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone
(336) 768-1270
Fax
(336) 765-6375
NPI assigned
May 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2011

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

Authorized official

Name
Mrs. Regina A Hayes
Title
Business Office Manager
Phone
(336) 659-4111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XX0005X Primary

Addresses

Primary practice location

170 Kimel Park Dr
Winston Salem, NC 27103-6946

Mailing address

PO Box 25626
Winston Salem, NC 27114-5626
Phone (336) 768-1270

Other identifiers 5

IdentifierTypeStateIssuer
27080OtherNCBLUE MEDICARE NUMBER
890110QMedicaidNC
0110QOtherNCBCBS GROUP NUMBER
CN4910OtherNCRR MEDICARE GROUP #
CD6584OtherNCRR MEDICARE GROUP #

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 59

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

View all 59

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302220800000",
    "number": "1124070115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25626",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271145626",
            "telephone_number": "336-768-1270",
            "fax_number": "336-765-6375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 KIMEL PARK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036946",
            "telephone_number": "336-768-1270",
            "fax_number": "336-765-6375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC SPECIALISTS OF THE CAROLINAS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2011-04-08",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "REGINA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "336-659-4111",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE MEDICARE NUMBER",
            "identifier": "27080",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890110Q",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "0110Q",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP #",
            "identifier": "CN4910",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP #",
            "identifier": "CD6584",
            "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 Apr 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.

Verify at the official NPI Registry.