Individual provider Active NPI

Stephen W Stroud

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Greensboro, NC
National Provider Identifier
1457424574
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
4540 Issued in NC
Practice address
301 East Wendover Ave Suite 111
Piedmont Oral Maxillofacial Fac Ctr
Greensboro, NC 27401
Phone
(336) 273-1000
Fax
(336) 275-9919
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 4540 NC Primary

Addresses

Primary practice location

301 East Wendover Ave Suite 111
Piedmont Oral Maxillofacial Fac Ctr
Greensboro, NC 27401

Mailing address

301 East Wendover Ave Suite 111
Piedmont Oral Maxillofacial Fac Ctr
Greensboro, NC 27401
Phone (336) 273-1000

Other identifiers 1

IdentifierTypeStateIssuer
8998158MedicaidNC

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101019000698 NC Practitioner - Oral Surgery 4082776661 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4540NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University Current Accepting new patients
East Carolina University CurrentSince Dec 2, 2020 Accepting new patients
East Carolina University CurrentSince Dec 2, 2020 Accepting new patients
Shenan Bradshaw DDS MD PA Oral & Maxillofacial Surgery PastSince Jun 3, 2025 Accepting new patients

Locations

1851 Macgregor Downs Rd
Greenville, NC 27834
Phone (252) 737-7000

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457424574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 EAST WENDOVER AVE SUITE 111",
            "address_2": "PIEDMONT ORAL MAXILLOFACIAL FAC CTR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27401",
            "telephone_number": "336-273-1000",
            "fax_number": "336-275-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 EAST WENDOVER AVE SUITE 111",
            "address_2": "PIEDMONT ORAL MAXILLOFACIAL FAC CTR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27401",
            "telephone_number": "336-273-1000",
            "fax_number": "336-275-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROUD",
        "first_name": "STEPHEN",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NC",
            "license": "4540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8998158",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.