Active NPI
Frederick Keith Stirewalt, PA-C
- Physician Assistant
- Winston Salem, NC
National Provider Identifier
1386127538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 100767
- Practice address
- Medical Center Blvd Faithhealth
Winston Salem, NC 27157-0001 - Phone
- (336) 716-5811
- NPI assigned
- Sep 13, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 100767 | NC | Primary |
| Hospice and Palliative Medicine (Internal Medicine) Physician | 207RH0002X | 100767 | NC |
Addresses
Primary practice location
Medical Center Blvd Faithhealth
Winston Salem, NC 27157-0001
Mailing address
Medical Center Blvd Faithhealth
Winston Salem, NC 27157-0001
Phone (336) 716-5811
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
- Physician Assistant
Interoperability endpoints
- fstirewalt2755242@carolinashealthcaresystem.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550793600000",
"number": "1386127538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MEDICAL CENTER BLVD FAITHHEALTH",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271570001",
"telephone_number": "336-716-5811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MEDICAL CENTER BLVD FAITHHEALTH",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271570001",
"telephone_number": "336-716-5811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STIREWALT",
"first_name": "FREDERICK",
"middle_name": "KEITH",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-13",
"last_updated": "2019-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "100767",
"primary": true
},
{
"code": "207RH0002X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hospice and Palliative Medicine",
"state": "NC",
"license": "100767",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Feb 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.