NPIMap

Organization Active NPI

Wake Forest Health Network LLC

Doing business as LiveWell Clinics

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
National Provider Identifier
1245006311
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
WAKE FOREST HEALTH NETWORK LLC
Doing business as
LiveWell Clinics
Practice address
Medical Center Boulevard
Ground Floor, Meads Hall
Winston Salem, NC 27106
Phone
(336) 716-2255
NPI assigned
Nov 30, 2023
Organization subpart
Yes
Parent organization
WAKE FOREST HEALTH NETWORK LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Authorized official

Name
Russell Mars Howerton
Title
Sr VP Network Phys & Hscmo
Phone
(336) 716-1331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

Medical Center Boulevard
Ground Floor, Meads Hall
Winston Salem, NC 27106

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 716-1331

Other practice location 1

1370 W D St
North Wilkesboro, NC 28659-3506
Phone (336) 716-2255

Other practice location 2

575 N Patterson Ave Ste 148
Winston Salem, NC 27101-4177
Phone (336) 716-2255

Other practice location 3

306 Westwood Ave Ste 401
High Point, NC 27262-4342
Phone (336) 716-2255

Other names 1

  • LiveWell Clinics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Corerstone HLTH Care55 organizations share this tax ID, including this one
Part of
Corerstone HLTH Care

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701734400000",
    "number": "1245006311",
    "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": "336-716-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BOULEVARD",
            "address_2": "GROUND FLOOR, MEADS HALL",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27106",
            "telephone_number": "336-716-2255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1370 W D St",
            "address_purpose": "LOCATION",
            "city": "North Wilkesboro",
            "state": "NC",
            "postal_code": "286593506",
            "country_code": "US",
            "telephone_number": "336-716-2255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "575 N Patterson Ave Ste 148",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271014177",
            "country_code": "US",
            "telephone_number": "336-716-2255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "306 Westwood Ave Ste 401",
            "address_purpose": "LOCATION",
            "city": "High Point",
            "state": "NC",
            "postal_code": "272624342",
            "country_code": "US",
            "telephone_number": "336-716-2255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WAKE FOREST HEALTH NETWORK LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAKE FOREST HEALTH NETWORK LLC",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A",
        "authorized_official_last_name": "HOWERTON",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "MARS",
        "authorized_official_title_or_position": "SR VP NETWORK PHYS & HSCMO",
        "authorized_official_telephone_number": "336-716-1331"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LiveWell Clinics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LiveWell Clinics",
            "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 Dec 5, 2023; 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.