Individual provider Active NPI

William Brockenbrough Newton III, MD

  • Vascular Surgery Physician
  • Statesville, NC
National Provider Identifier
1215912258
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
2004-01550 Issued in NC
Practice address
770 Hartness Rd
Statesville, NC 28677-3376
Phone
(704) 873-5594
Fax
(704) 871-9888
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 2004-01550 NC Primary

Addresses

Primary practice location

770 Hartness Rd
Statesville, NC 28677-3376

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 716-0238

Other practice location 1

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-9502

Other identifiers 1

IdentifierTypeStateIssuer
89138CEMedicaidNC

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
I20041122001153 NC Practitioner - Vascular SurgeryPractitioner - General SurgeryPractitioner - Internal Medicine 0042275778 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Medical University of South Carolina College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iredell Physician Network LLCGroup PAC ID 0749345007, 91 clinicians

Practice addresses (Care Compare)

770 Hartness Rd
Statesville, NC 28677-3376
Phone (704) 883-3378

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)81
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004-01550NCMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Wound Specialists of North Carolina, PLLC CurrentSince Oct 1, 2024 Accepting new patients
Wake Forest University Health Sciences CurrentSince Jun 1, 2011 Accepting new patients
Iredell Physician Network LLC CurrentSince Jun 1, 2021 Accepting new patients
Iredell Physician Network LLC CurrentSince Jun 1, 2021 Accepting new patients
Iredell Physician Network LLC Past Accepting new patients
WRMC Hospital Operating Corporation Past Accepting new patients

Locations

1814 Westchester Dr
Ste 101
High Point, NC 27262
Phone (336) 802-2105

35 Memorial Dr
Pinehurst, NC 28374
Phone (910) 715-3376

770 Hartness Rd
Statesville, NC 28677
Phone (704) 873-1851

1714 Davie Ave
Statesville, NC 28677
Phone (704) 768-0542

766 Hartness Rd
Statesville, NC 28677
Phone (704) 838-2182

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: william.newtoniii@iredell.cernerdirect.com
  • Direct secure messaging: wnewton2754221@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1215912258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-716-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 HARTNESS RD",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773376",
            "telephone_number": "704-873-5594",
            "fax_number": "704-871-9888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271570001",
            "country_code": "US",
            "telephone_number": "336-716-9502",
            "fax_number": "336-716-7112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEWTON",
        "first_name": "WILLIAM",
        "middle_name": "BROCKENBROUGH",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NC",
            "license": "2004-01550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89138CE",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.