Individual provider Active NPI

Brian Edward Kouri, MD

  • Vascular & Interventional Radiology Physician
  • Winston Salem, NC
National Provider Identifier
1346273539
Registry record updated Oct 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
2006-00966 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone
(336) 716-2255
NPI assigned
Jul 9, 2006
Last updated
Oct 5, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 200600966 NC
Vascular & Interventional Radiology Physician 2085R0204X 2006-00966 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-0001

Mailing address

PO Box 344
Winston Salem, NC 27102-0344
Phone (336) 716-2255

Other identifiers 1

IdentifierTypeStateIssuer
5904445MedicaidNC

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
I20061002000308 NC Practitioner - Diagnostic Radiology 0648275396 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of North Carolina at Chapel Hill School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wake Forest Baptist Imaging LLCGroup PAC ID 3173681681, 76 clinicians

Practice addresses (Care Compare)

1370 W D St
North Wilkesboro, NC 28659-3506
Phone (336) 651-8760

1917 W Park Drivce
N Wilkesboro, NC 28659-3506
Phone (336) 667-3762

265 Executive Park Blvd
Winston Salem, NC 27103-1503
Phone (336) 765-5722

4515 Premier Dr
High Point, NC 27265-8356

601 N Elm St
High Point, NC 27262-4331
Phone (336) 716-2734

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200600966NCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jul 1, 2008 Accepting new patients
Wake Forest Baptist Imaging LLC Diagnostic Radiology CurrentSince Sep 27, 2024 Accepting new patients
Wake Forest Baptist Imaging, LLC Diagnostic Radiology CurrentSince Oct 25, 2009 Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients
Triad Radiology Associates PLLC Diagnostic Radiology Past Accepting new patients

Locations

10 Medical Park Dr
Lexington, NC 27292
Phone (336) 236-4681

2 Hospital Dr
Lexington, NC 27292
Phone (336) 243-2436

5 Medical Park Dr
Lexington, NC 27292
Phone (336) 236-2500

830 Rockford St
Mount Airy, NC 27030
Phone (336) 719-7000

265 Executive Park Blvd
Winston Salem, NC 27103
Phone (336) 765-5722

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

Interoperability endpoints

  • Direct secure messaging: bkouri2754362@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507161600000",
    "number": "1346273539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 344",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271020344",
            "telephone_number": "336-716-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOURI",
        "first_name": "BRIAN",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2017-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "200600966",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NC",
            "license": "2006-00966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5904445",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.