John Anderson Fagg, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

200001199779 Issued in NC

Practice address

2901 Maplewood Ave
Winston-Salem, NC 27103

Phone

(336) 765-8620

Fax

(336) 768-6236

NPI assigned

May 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Forsyth Plastic Surgical Assoc PA

  • Plastic Surgery Physician
  • Winston Salem, NC
  • NPI 1811090475
  Medicare reassignment NPD Authorized official
• Plastic Surgery Center of NC Inc

  • Plastic and Reconstructive Surgery Physician
  • Winston Salem, NC
  • NPI 1013002138
  NPD (past) Authorized official

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355702400000",
    "number": "1316905508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 MAPLEWOOD AVE",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-765-8620",
            "fax_number": "336-768-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 MAPLEWOOD AVE",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-765-8620",
            "fax_number": "336-768-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGG",
        "first_name": "JOHN",
        "middle_name": "ANDERSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2012-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NC",
            "license": "200001199779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "240001710",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8931036",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "60623",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "31036",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "912",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Ann Factor
• Anita Ellen Fadden, LCAS-A
• Emmanuel Adegoke Fadeyi, MD
• Oluwatoyin Alaba Fadeyi, DNP
• Fafa Solutions LLC
• Jon Fredrick Faigle, CRNA
• Rachel Faile, LPT
• Elizabeth Anne Fain, OTR L
• Raquia Fair, CNA1/2 MT,
• Andrew Thomas Fairchild, MD

• Plastic Surgery Physician in Winston-Salem, NC
• Providers in Winston-Salem, NC by specialty
• Plastic Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.