Organization Active NPI

Highroad Pediatrics

Doing business as Winston Salem Pediatrics & Kernersville Pediatrics

  • Pediatrics Physician
  • Winston Salem, NC
National Provider Identifier
1154348597
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
HIGHROAD PEDIATRICS
Doing business as
Winston Salem Pediatrics & Kernersville Pediatrics
Practice address
2808 Maplewood Ave
Winston Salem, NC 27103-4138
Phone
(336) 765-9000
Fax
(336) 765-5702
NPI assigned
Jul 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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

Authorized official

Name
Scott Eric Tolley
Title
Office Manager
Phone
(336) 765-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X NC Primary

Addresses

Primary practice location

2808 Maplewood Ave
Winston Salem, NC 27103-4138

Mailing address

2808 Maplewood Ave
Winston Salem, NC 27103-4138
Phone (336) 765-9000

Other identifiers 2

IdentifierTypeStateIssuer
5903822MedicaidNC
5903823MedicaidNC

Other names 1

  • Winston Salem Pediatrics & Kernersville Pediatrics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Highroad Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220400000000",
    "number": "1154348597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 MAPLEWOOD AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034138",
            "telephone_number": "336-765-9000",
            "fax_number": "336-765-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 MAPLEWOOD AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034138",
            "telephone_number": "336-765-9000",
            "fax_number": "336-765-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHROAD PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2008-09-03",
        "status": "A",
        "authorized_official_last_name": "TOLLEY",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "336-765-9000"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903822",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903823",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Winston Salem Pediatrics & Kernersville Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 3, 2008; 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.