Active NPI
Jordan Elijah Rotstein Tannenbaum, MD
- Cardiovascular Disease Physician
- Winston Salem, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 2021-02064
- Practice address
- Medical Center Blvd
Winston Salem, NC 27157-1900 - Phone
- (336) 716-6674
- NPI assigned
- Apr 11, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 2021-02064 | NC | Primary |
| Internal Medicine Physician | 207R00000X | 2021-02064 | NC |
Addresses
Primary practice location
Medical Center Blvd
Winston Salem, NC 27157-1900
Mailing address
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-6674
Other practice location 1
625 19th St S
Birmingham, AL 35233-1900
Phone (205) 934-9666
Other practice location 2
186 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone (336) 277-2000
Other practice location 3
694 Riverside Dr
Mount Airy, NC 27030-3117
Phone (336) 719-7892
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Novant Health Medical Group, LLC
Practice addresses (Care Compare)
1226 Eastchester Dr
Suite 100
High Point, NC 27265-3116
Phone (336) 481-8540
186 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone (336) 277-2000
3515 W Market St
Suite 110
Greensboro, NC 27403-4439
Phone (336) 660-5220
Hospital & facility affiliations
- Novant Health Forsyth Medical Center
- Northern Regional Hospital
- Twin County Regional Hospital
- North Carolina Baptist Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| The Moses H Cone Memorial Hospital Operating Corporation | Current | Accepting new patients | |
| Novant Health Thomasville Medical Center, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| The Presbyterian Hospital | Current | Accepting new patients | |
| Forsyth Memorial Hospital, Inc. | Current | Accepting new patients | |
| Novant Health Thomasville Medical Center LLC | Current | Accepting new patients | |
| Forsyth Memorial Hospital, Inc. | Cardiovascular Disease | Current | Accepting new patients |
| Forsyth Memorial Hospital Inc | Cardiovascular Disease | Current | Accepting new patients |
| The Moses H. Cone Memorial Hospital Operating Corporation | Internal Medicine | Current | Accepting new patients |
| Novant Health Medical Group, LLC | Cardiovascular Disease | Current | Accepting new patients |
| The Presbyterian Hospital | Internal Medicine | Current | Accepting new patients |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| The Presbyterian Hospital | Internal Medicine | Current | Accepting new patients |
| The Moses H Cone Memorial Hospital Operating Corporation | Internal Medicine | Current | Accepting new patients |
| Novant Health Medical Group, LLC | Cardiovascular Disease | Current | Accepting new patients |
| Forsyth Memorial Hospital, Inc | Past | Accepting new patients |
Locations
125 Queens Rd
Charlotte, NC 28204
Phone (980) 302-6380
200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424
125 Baldwin Ave
Ste 200
Charlotte, NC 28204
Phone (704) 384-5043
7114 Village Medical Cir
Clemmons, NC 27012
Phone (336) 893-2440
6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473
189 Samaritans Ridge Rd
Elkin, NC 28621
Phone (336) 526-3003
1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000
1126 N Church St
Ste 300
Greensboro, NC 27401
Phone (336) 547-1700
2400 W Friendly Ave
Greensboro, NC 27403
Phone (336) 832-1100
509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970
3515 W Market St
Ste 110
Greensboro, NC 27403
Phone (336) 299-0099
1226 Eastchester Dr
#100
High Point, NC 27265
Phone (336) 481-8540
291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181
1710 Kernersville Medical Pkwy
Ste 205
Kernersville, NC 27284
Phone (336) 983-4500
144 Forest Hill Rd
Ste 144146
Lexington, NC 27295
Phone (336) 481-1730
694 Riverside Dr
Mount Airy, NC 27030
Phone (336) 719-7892
5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441
207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000
211 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-1191
2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300
725 Highland Oaks Dr
Ste 200
Winston Salem, NC 27103
Phone (336) 277-2620
2025 Frontis Plaza Blvd
Ste 100
Winston Salem, NC 27103
Phone (336) 718-6199
186 Kimel Park Dr
Winston Salem, NC 27103
Phone (336) 277-2000
185 Kimel Park Dr
Winston Salem, NC 27103
Phone (336) 277-2000
3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800
Interoperability endpoints
- jtannenbaum1080093@direct.novanthealth.org
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.
-
- Family Medicine Physician
- Winston Salem, NC
- NPI 1104548874
-
- Endocrinology, Diabetes & Metabolism Physician
- Charlotte, NC
- NPI 1306950282
-
- Neurology with Special Qualifications in Child Neurology Physician
- Charlotte, NC
- NPI 1366409492
-
- Specialist
- Thomasville, NC
- NPI 1033160205
-
- Internal Medicine Physician
- Greensboro, NC
- NPI 1013265909
-
- Geriatric Medicine (Internal Medicine) Physician
- Charlotte, NC
- NPI 1053365817
-
- Cardiovascular Disease Physician
- Winston Salem, NC
- NPI 1114200771
-
- Cardiovascular Disease Physician
- Winston Salem, NC
- NPI 1932935475
-
- Obstetrics & Gynecology Physician
- Matthews, NC
- NPI 1386506137
-
- Cardiovascular Disease Physician
- Greensboro, NC
- NPI 1568973360
-
- Cardiovascular Disease Physician
- High Point, NC
- NPI 1972106268
-
- Hematology & Oncology Physician
- Winston Salem, NC
- NPI 1649159609
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Winston Salem, NC
- NPI 1447200233
-
- Psychiatric Hospital Unit
- Winston Salem, NC
- NPI 1063480531
-
- Rehabilitation Hospital Unit
- Winston Salem, NC
- NPI 1114995677
-
- General Acute Care Hospital
- Winston Salem, NC
- NPI 1144211301
-
- Clinical Medical Laboratory
- Winston Salem, NC
- NPI 1609162098
Hospital
-
- Pediatric Adolescent Medicine Physician
- Winston Salem, NC
- NPI 1912179219
Hospital
-
- General Acute Care Hospital
- Mount Airy, NC
- NPI 1366449282
-
- General Acute Care Hospital
- Galax, VA
- NPI 1114292141
-
- Physical Therapy Clinic/Center
- Galax, VA
- NPI 1801161369
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721779200000",
"number": "1144727645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MEDICAL CENTER BLVD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271570001",
"telephone_number": "336-716-6674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MEDICAL CENTER BLVD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271571900",
"telephone_number": "336-716-6674"
}
],
"practiceLocations": [
{
"address_1": "625 19th St S",
"address_purpose": "LOCATION",
"city": "Birmingham",
"state": "AL",
"postal_code": "352331900",
"country_code": "US",
"telephone_number": "205-934-9666",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "186 Kimel Park Dr",
"address_purpose": "LOCATION",
"city": "Winston Salem",
"state": "NC",
"postal_code": "271036946",
"country_code": "US",
"telephone_number": "336-277-2000",
"fax_number": "336-277-2050",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "694 Riverside Dr",
"address_purpose": "LOCATION",
"city": "Mount Airy",
"state": "NC",
"postal_code": "270303117",
"country_code": "US",
"telephone_number": "336-719-7892",
"fax_number": "336-719-7898",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TANNENBAUM",
"first_name": "JORDAN",
"middle_name": "ELIJAH ROTSTEIN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-11",
"last_updated": "2024-07-24",
"certification_date": "2024-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NC",
"license": "2021-02064",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NC",
"license": "2021-02064",
"primary": false
}
],
"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 Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.