Wellpath Community Care Centers of North Carolina, PC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

WELLPATH COMMUNITY CARE CENTERS OF NORTH CAROLINA, PC

Practice address

755 Highland Oaks Dr Ste 204
Winston Salem, NC 27103-7106

Phone

(336) 522-5235

NPI assigned

Mar 29, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Edward Conyers O'Bryan, MD

Title

Incorporator

Phone

(843) 323-0833

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adam Shaver, BA, CASAC

  • Addiction (Substance Use Disorder) Counselor
  • North Syracuse, NY
  • NPI 1033354600
  NPD

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643673600000",
    "number": "1346827862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1283 MURFREESBORO PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372172432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 HIGHLAND OAKS DR STE 204",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271037106",
            "telephone_number": "336-522-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLPATH COMMUNITY CARE CENTERS OF NORTH CAROLINA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-29",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A",
        "authorized_official_last_name": "O'BRYAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "CONYERS",
        "authorized_official_title_or_position": "INCORPORATOR",
        "authorized_official_telephone_number": "843-323-0833",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olga Weldon
• Laura Welfare, LPC
• Robert Stephen Weller, MD
• Wellmood PLLC
• Wellness Medical Essentials & Co LLC
• Adam Haynsworth Wells, MD
• Avery Higgins Wells, RN
• Brian J Wells, MD
• Hollis Ella Wells
• Peggie Wells, LCSWA, MSW

• Health Service Clinic/Center in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Health Service Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.