Cooper Scurry Facial Plastic Surgery Center PLLC

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

Legal business name

COOPER SCURRY FACIAL PLASTIC SURGERY CENTER PLLC

Practice address

855 Bethesda Rd
Winston Salem, NC 27103-3026

Phone

(336) 671-1679

NPI assigned

May 15, 2023

Organization subpart

No

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

Authorized official

Name

Dr. William Cooper Scurry Jr., MDNPI 1114144979

Title

Owner

Phone

(336) 671-1679

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William Cooper Scurry Jr., M.D.

  • Otolaryngology Physician
  • Winston Salem, NC
  • NPI 1114144979
  Medicare reassignment NPD Authorized official
• Cherryel Sink Scurry

  • Registered Dietitian
  • Winston Salem, NC
  • NPI 1891618252
  NPD (past)

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1508556358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 BETHESDA RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033026",
            "telephone_number": "336-671-1679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 BETHESDA RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033026",
            "telephone_number": "336-671-1679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPER SCURRY FACIAL PLASTIC SURGERY CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-13",
        "status": "A",
        "authorized_official_last_name": "SCURRY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "COOPER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-671-1679",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maille Coombs, M.S. CCC-SLP
• Andrea Magri Coomer, CRNA
• Edward Bradley Coomer, CRNA
• Grayson Coon, MD
• Riley James Coon
• Alexus M Cooper, MD
• Axel Cooper, M.D.
• Courtney Cooper
• Jennifer Mickle Cooper, M.D.
• Lauren Claire Cooper

• Facial Plastic Surgery Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Facial Plastic Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.