NPIMap

Organization Active NPI

Wake Forest University Health Sciences

  • Anesthesiology Physician
  • Winston Salem, NC
National Provider Identifier
1407891575
Registry record updated Jan 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
WAKE FOREST UNIVERSITY HEALTH SCIENCES
Practice address
3333 Silas Creek Pkwy
Winston-Salem, NC 27103-3013
Phone
(336) 718-4941
NPI assigned
Jun 20, 2006
Last updated
Jan 14, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
WAKE FOREST UNIVERSITY HEALTH SCIENCESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 14, 2008

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

Authorized official

Name
William Applegate, MD
Title
Interim Pres, Wfu Health Sciences
Phone
(336) 716-4424

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

3333 Silas Creek Pkwy
Winston-Salem, NC 27103-3013

Mailing address

2000 Frontis Plaza Blvd
Suite 300
Winston-Salem, NC 27103-5616
Phone (336) 718-4941

Other identifiers 2

IdentifierTypeStateIssuer
89013K2MedicaidNC
02325OtherNCBCBS OF NC

Other names 1

  • WFU Health Sciences-OB Anes Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000436 NC Part B Supplier - Clinic/Group Practice 4486564952 Receives reassigned benefits from 3,530 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Wake Forest University Health Sciences

Locations

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

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1407891575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 FRONTIS PLAZA BLVD",
            "address_2": "SUITE 300",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271035616",
            "telephone_number": "336-718-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SILAS CREEK PKWY",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "telephone_number": "336-718-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE FOREST UNIVERSITY HEALTH SCIENCES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAKE FOREST UNIVERSITY HEALTH SCIENCES",
        "enumeration_date": "2006-06-20",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "APPLEGATE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "INTERIM PRES, WFU HEALTH SCIENCES",
        "authorized_official_telephone_number": "336-716-4424",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89013K2",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "02325",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WFU Health Sciences-OB Anes",
            "code": "5",
            "type": "Other 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 Jan 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.