Active NPI
Paula Valeria Vergara-Wentland, M.D.
- Diagnostic Radiology Physician
- Winston Salem, NC
National Provider Identifier
1356623714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 175542
- Practice address
- 455 Summergate Dr
Winston Salem, NC 27103-5538 - Phone
- (518) 250-8919
- NPI assigned
- Sep 12, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 175542 | NC | Primary |
Addresses
Primary practice location
455 Summergate Dr
Winston Salem, NC 27103-5538
Mailing address
455 Summergate Dr.
Winston-Salem, NC 27103-3501
Phone (518) 250-8919
Other names 1
- Paula Valeria Vergara
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 175542 | NC | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490227200000",
"number": "1356623714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 SUMMERGATE DR.",
"city": "WINSTON-SALEM",
"state": "NC",
"postal_code": "271033501",
"telephone_number": "518-250-8919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 SUMMERGATE DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271035538",
"telephone_number": "518-250-8919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERGARA-WENTLAND",
"first_name": "PAULA",
"middle_name": "VALERIA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-12",
"last_updated": "2017-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NC",
"license": "175542",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "PAULA",
"last_name": "VERGARA",
"middle_name": "VALERIA",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.