Forsyth Memorial Hospital Inc

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

FORSYTH MEMORIAL HOSPITAL INC

Practice address

2010 Baldwin Lane
Winston Salem, NC 27103

Phone

(336) 277-1717

Fax

(336) 277-1718

NPI assigned

Jun 11, 2007

Organization subpart

No

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

Authorized official

Name

Leea Jeanine Walton

Title

RCS Manager

Phone

(704) 316-6081

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Novant Health Urology Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

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

• Ashley Jean Fairbrother Brandon, M.D.

  • Urology Physician
  • Burlington, NC
  • NPI 1790912574

  Urology

  NPD
• Melissa Sue Hergert

  • Nurse Practitioner
  • Winston Salem, NC
  • NPI 1982479069
  NPD
• Blake Elliot Johnson, MD, M.SC.

  • Urology Physician
  • Charlotte, NC
  • NPI 1497389142

  Urology

  NPD
• Paul David McClain, M.D.

  • Urology Physician
  • Winston Salem, NC
  • NPI 1235470261

  Urology

  NPD
• Ernest Frederick McPhail III, MD

  • Urology Physician
  • Clemmons, NC
  • NPI 1174644314

  Urology

  NPD
• Alden Henry Reine Jr., MD

  • Urology Physician
  • Lincolnton, NC
  • NPI 1043264484

  Urology

  NPD
• Mary Elizabeth Westerman, M.D.

  • Urology Physician
  • Chapel Hill, NC
  • NPI 1376959189

  Urology

  NPD
• Gianpaolo Carpinito, MD

  • Urology Physician
  • Boston, MA
  • NPI 1609337153

  Urology

  NPD

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689120000000",
    "number": "1275736795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-277-1717",
            "fax_number": "337-277-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 BALDWIN LANE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-277-1717",
            "fax_number": "336-277-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORSYTH MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "LEEA",
        "authorized_official_middle_name": "JEANINE",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "704-316-6081"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5909023",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Urology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Forsyth Memorial Hospital Inc
• Forsyth Memorial Hospital Inc
• Forsyth Memorial Hospital Inc
• Forsyth Memorial Hospital Inc
• Forsyth Memorial Hospital Inc
• Forsyth Memorial Hospital Inc
• Forsyth Memorial Hospital Inc
• Forsyth Memorial Hospital Inc
• Forsyth Memorial Hospital Inc
• Forsyth Memorial Hospital Inc

• All providers in Winston Salem, NC
• Urology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.