Active NPI
Gary Darneville Poleynard, MD
- Gastroenterology Physician
- Winston-Salem, NC
National Provider Identifier
1508800038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 95-01064
- Practice address
- 2025 Frontis Plaza Blvd
Suite 200
Winston-Salem, NC 27103-5663 - Phone
- (336) 768-6211
- Fax
- (336) 768-6869
- NPI assigned
- Jun 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 95-01064 | NC | Primary |
Addresses
Primary practice location
2025 Frontis Plaza Blvd
Suite 200
Winston-Salem, NC 27103-5663
Mailing address
2025 Frontis Plaza Blvd
Suite 200
Winston-Salem, NC 27103-5663
Phone (336) 768-6211
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95-01064 | NC | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315958400000",
"number": "1508800038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2025 FRONTIS PLAZA BLVD",
"address_2": "SUITE 200",
"city": "WINSTON-SALEM",
"state": "NC",
"postal_code": "271035663",
"telephone_number": "336-768-6211",
"fax_number": "336-768-6869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2025 FRONTIS PLAZA BLVD",
"address_2": "SUITE 200",
"city": "WINSTON-SALEM",
"state": "NC",
"postal_code": "271035663",
"telephone_number": "336-768-6211",
"fax_number": "336-768-6869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLEYNARD",
"first_name": "GARY",
"middle_name": "DARNEVILLE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2011-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NC",
"license": "95-01064",
"primary": true
}
],
"identifiers": [],
"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 Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.