William Bryan Jennings, DO
Individual provider Active NPI Orthopaedic Surgery Physician · Winston Salem, NC
NPI 1306849047 · NPPES record last updated Aug 13, 2020
Key facts
- NPI
- 1306849047
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- License
- 200400218 (NC)
- Practice address
- 170 Kimel Park Dr
Winston Salem, NC 27103 - Phone
- (336) 768-1270
- Fax
- (336) 765-6375
- NPI assigned
- May 26, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Orthopedic Surgery
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Orthocarolina
Proactive Therapy of North Carolina Inc
Practice addresses (Care Compare)
170 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone (704) 323-2276
20 W Medical CT
Marion, NC 28752-4968
Phone (828) 659-8049
Hospital & facility affiliations
- Medi Home Health & Hospice
- Adoration Home Health
- Bayada Home Health Care, Inc
- Enhabit Home Health
- Novant Health Forsyth Medical Center
- Lifebrite Community Hospital of Stokes
- Northern Regional Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 94 of 100
- Quality
- 81.63
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hip replacement | 14 |
| Knee replacement | 16 |
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 18 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 68 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040721000901 | NC | Practitioner - Orthopedic Surgery | 6507846516 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthocarolina | Orthopaedic Surgery | Current |
Accepting new patients |
| Orthocarolina | Orthopaedic Surgery | Current |
Accepting new patients |
| Tuckahoe Orthopaedic Associates, LTD | Orthopaedic Surgery | Past |
Accepting new patients |
Locations
1915 Randolph Rd
Charlotte, NC 28207
Phone (704) 339-1000
4601 Park Rd
Ste 300
Charlotte, NC 28209
Phone (704) 323-2090
402 W King St
King, NC 27021
Phone (336) 529-4304
170 Kimel Park Dr
Winston Salem, NC 27103
Phone (336) 765-7058
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 200400218 | NC | |
| Orthopaedic Surgery Physician | 207X00000X | 200400218 | NC | Yes |
Addresses
Primary practice location
170 Kimel Park Dr
Winston Salem, NC 27103
Mailing address
4601 Park Rd Ste 250
Charlotte, NC 28209-2373
Phone (704) 323-2000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89136WG | Medicaid | NC | |
| 1306849047 | Medicaid | NC | |
| 0223770001 | Other | NC | MEDICARE DME |
Other providers in Winston Salem, NC
- La'Nasia Jenkins
- Cynthia Jennings
- Emily Smith Jennings
- Jerome Edwin Jennings
- Krystal Jennings
- Chelsea Jayne Jensen
- Chaewon Jeong
- Erin Stephany Jepsen
- Jeremiah'S Place
- Traci Sparks Jermyn
All providers in Winston Salem, NC · Orthopaedic Surgery Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.