Individual provider Active NPI

Henry Joe Taylor IV, DPM

  • Foot & Ankle Surgery Podiatrist
  • Winston Salem, NC
National Provider Identifier
1306342597
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
810 Issued in NC
Practice address
3057 Trenwest Dr
Winston Salem, NC 27103-3220
Phone
(336) 765-0710
NPI assigned
Apr 5, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 810 NC
Student in an Organized Health Care Education/Training Program 390200000X
Foot & Ankle Surgery Podiatrist 213ES0103X 810 NC Primary

Addresses

Primary practice location

3057 Trenwest Dr
Winston Salem, NC 27103-3220

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

1407 Clifton Pl
Lakewood, OH 44107-3412

Other practice location 2

1407 Clifton Pl
Lakewood, OH 44107-3412
Phone (419) 215-5085

Other practice location 3

20 York Street - YNHH (Podiatry)
New Haven, CT 06510-3220
Phone (203) 688-4242

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230104001410 NC Practitioner - Podiatry 6507116548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

3057 Trenwest Dr
Winston Salem, NC 27103-3220
Phone (336) 765-0710

Hospital & facility affiliations

  • Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue78
Removal of skin lesions1-10
Removal of nail tissue489
Removal or shaving of skin growth432

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1014CTMDSports Physician Chiropractor
810NCMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Podiatrist CurrentSince Dec 1, 2022 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Dec 1, 2022 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Mark Brian Friedman, DPM, PLLC Podiatrist Past Accepting new patients

Locations

4741 Randolph Rd
#100
Charlotte, NC 28211
Phone (704) 365-6730

7126 Village Medical Cir
Clemmons, NC 27012
Phone (336) 448-2427

445 Pineview Dr
Ste 230
Kernersville, NC 27284
Phone (336) 760-3007

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

3057 Trenwest Dr
Winston Salem, NC 27103
Phone (336) 765-0710

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: htaylor1059893@direct.trinity-health.org
  • Direct secure messaging: htaylor1086680@direct.novanthealth.org

Organizations & group practices 4

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

Hospital & facility affiliations 1

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": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1306342597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3057 TRENWEST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033220",
            "telephone_number": "336-765-0710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1407 Clifton Pl",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "OH",
            "postal_code": "441073412",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1407 Clifton Pl",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "OH",
            "postal_code": "441073412",
            "country_code": "US",
            "telephone_number": "419-215-5085",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 York Street - YNHH (Podiatry)",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-688-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "HENRY",
        "middle_name": "JOE",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-05",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NC",
            "license": "810",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.