Individual provider Active NPI

Samuel Patrick Stuart Jr., M.D.

  • Surgery Physician
  • Winston Salem, NC
National Provider Identifier
1447212667
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
30574 Issued in NC
Practice address
3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone
(336) 718-9080
Fax
(336) 718-9085
NPI assigned
Apr 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 30574 NC
Surgery Physician 208600000X 30574 NC Primary

Addresses

Primary practice location

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-7840

Other identifiers 2

IdentifierTypeStateIssuer
1447212667MedicaidNC
7980694MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sstuart95562@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100512000543 NC Practitioner - General Surgery 5496831844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of North Carolina at Chapel Hill School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

2915 Lyndhurst Ave
Winston Salem, NC 27103-4005
Phone (336) 718-9080

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30574NCMDAddiction (Substance Use Disorder) Counselor
30579NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Medical Group, Inc. CurrentSince Sep 11, 2012 Accepting new patients
Triad Surgical Associates, P.a. Specialist Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Sep 11, 2012 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

330 Billingsley Rd
Ste 202
Charlotte, NC 28211
Phone (704) 316-2350

7126 Village Medical Cir
Clemmons, NC 27012
Phone (336) 448-2427

1710 Kernersville Medical Pkwy
Ste 202
Kernersville, NC 27284
Phone (336) 564-4873

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

1900 S Hawthorne Rd
#480
Winston Salem, NC 27103
Phone (336) 277-1655

2915 Lyndhurst Ave
Winston Salem, NC 27103
Phone (336) 760-0558

1900 S Hawthorne Rd
Ste 480
Winston Salem, NC 27103
Phone (336) 765-0155

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

760 Highland Oaks Dr
Ste 200
Winston Salem, NC 27103
Phone (336) 277-4380

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: sstuart95562@direct.novanthealth.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1447212667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-7840",
            "fax_number": "704-384-7830"
        },
        {
            "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": "336-718-9080",
            "fax_number": "336-718-9085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUART",
        "first_name": "SAMUEL",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "30574",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "30574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447212667",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7980694",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sstuart95562@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2915 Lyndhurst Ave",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271034005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.