NPIMap

Organization Active NPI

Wake Forest University Health Sciences

  • Ophthalmology Physician
  • Greensboro, NC
National Provider Identifier
1225139249
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
WAKE FOREST UNIVERSITY HEALTH SCIENCES
Practice address
1014 N Elm St
Greensboro, NC 27401-1424
Phone
(336) 274-2149
NPI assigned
Sep 25, 2006
Last updated
Jan 15, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
WAKE FOREST UNIVERSITY HEALTH SCIENCESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Authorized official

Name
William B Applegate, MD
Title
Interim Pres, Wfu Health Sciences
Phone
(336) 716-4424

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

1014 N Elm St
Greensboro, NC 27401-1424

Mailing address

1014 N Elm St
Greensboro, NC 27401-1424
Phone (336) 274-2149

Other identifiers 1

IdentifierTypeStateIssuer
5907377MedicaidNC

Other names 1

  • WFU Ophthalmic Consultants Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000436 NC Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 3,530 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Wake Forest University Health Sciences

Locations

1014 N Elm St
Greensboro, NC 27401
Phone (336) 274-2149

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1225139249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011424",
            "telephone_number": "336-274-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011424",
            "telephone_number": "336-274-2149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE FOREST UNIVERSITY HEALTH SCIENCES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAKE FOREST UNIVERSITY HEALTH SCIENCES",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "APPLEGATE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "INTERIM PRES, WFU HEALTH SCIENCES",
        "authorized_official_telephone_number": "336-716-4424",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5907377",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WFU Ophthalmic Consultants",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.