Individual provider Active NPI

Johnathan D Rhyne

  • Pediatrics Physician
  • Winston Salem, NC
National Provider Identifier
1285606210
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
200500241 Issued in NC
Practice address
3746 Vest Mill Rd
Winston Salem, NC 27103-2912
Phone
(336) 774-0710
Fax
(336) 774-0707
NPI assigned
Feb 3, 2006
Last updated
Nov 5, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 200500241 NC Primary

Addresses

Primary practice location

3746 Vest Mill Rd
Winston Salem, NC 27103-2912

Mailing address

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2011

Other identifiers 1

IdentifierTypeStateIssuer
5900617MedicaidNC

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
I20050607001326 NC Practitioner - Pediatric Medicine 6406899798 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200500241NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Sep 29, 2014 Accepting new patients
Greenville Pediatric Services, Inc Pediatrics Past Accepting new patients
Wake Forest University Baptist Medical Center Community Physicians Pediatrics Past Accepting new patients

Locations

3746 Vest Mill Rd
Winston Salem, NC 27103
Phone (336) 713-0024

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

Interoperability endpoints

  • Direct secure messaging: jrhyne2754755@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1285606210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3746 VEST MILL RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032912",
            "telephone_number": "336-774-0710",
            "fax_number": "336-774-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHYNE",
        "first_name": "JOHNATHAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200500241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900617",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.