NPIMap

Organization Active NPI

Maplewood Psychiatric Associates, PA

  • Specialist
  • Winston Salem, NC
National Provider Identifier
1417130253
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
16722 Issued in NC
Legal business name
MAPLEWOOD PSYCHIATRIC ASSOCIATES, PA
Practice address
2830 Maplewood Ave
Suite a
Winston Salem, NC 27103-4100
Phone
(336) 768-2424
Fax
(336) 768-1857
NPI assigned
Dec 16, 2007
Last updated
Feb 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Authorized official

Name
Dr. Ali Jarrahi, M.D.NPI 1932174786
Title
President
Phone
(336) 768-2424

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 16722 NC Primary

Addresses

Primary practice location

2830 Maplewood Ave
Suite a
Winston Salem, NC 27103-4100

Mailing address

2830 Maplewood Ave
Suite a
Winston Salem, NC 27103-4100
Phone (336) 768-2424

Other identifiers 2

IdentifierTypeStateIssuer
45827OtherNCBLUE CROSS BLUE SHIELD
8945827MedicaidNC

National Provider Directory

National Provider Directory

Locations

2830 Maplewood Ave
Winston Salem, NC 27103

2830 Maplewood Ave
Ste A
Winston Salem, NC 27103
Phone (336) 331-3480

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1197763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391990400000",
    "number": "1417130253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 MAPLEWOOD AVE",
            "address_2": "SUITE A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034100",
            "telephone_number": "336-768-2424",
            "fax_number": "336-768-1857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 MAPLEWOOD AVE",
            "address_2": "SUITE A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034100",
            "telephone_number": "336-768-2424",
            "fax_number": "336-768-1857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLEWOOD PSYCHIATRIC ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-16",
        "last_updated": "2014-02-10",
        "status": "A",
        "authorized_official_last_name": "JARRAHI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-768-2424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "16722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "45827",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8945827",
            "state": "NC"
        }
    ],
    "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 10, 2014; 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.