Individual provider Active NPI

Grey Wilson Fortenbery

  • Plastic Surgery Physician
  • Hickory, NC
National Provider Identifier
1518426865
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
202501299 Issued in NC
Practice address
315 19TH St SE BLDG 100
Hickory, NC 28602-4230
Phone
(828) 328-3500
Fax
(828) 328-8777
NPI assigned
Mar 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Plastic Surgery Physician 208200000X 202501299 NC Primary

Addresses

Primary practice location

315 19TH St SE BLDG 100
Hickory, NC 28602-4230

Mailing address

1072 X Ray Dr
Gastonia, NC 28054-7488
Phone (980) 399-6330

Other practice location 1

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-4780

Other practice location 2

1927 3rd Avenue Ln SE
Hickory, NC 28602-2960
Phone (828) 328-3500

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
I20250523002144 NC Practitioner - Plastic and Reconstructive Surgery 8022341726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Brody School of Medicine at East Carolina University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Plastic Surgery and Dermatology PAGroup PAC ID 6800875188, 56 clinicians

Practice addresses (Care Compare)

315 19TH St SE
Hickory, NC 28602-4230
Phone (828) 325-9849

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision74
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202501299NCMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Plastic Surgery & Dermatology PA CurrentSince Mar 14, 2025 Accepting new patients
Piedmont Plastic Surgery and Dermatology PastSince Mar 14, 2025 Accepting new patients

Locations

959 Cox Rd
Gastonia, NC 28054
Phone (704) 866-0106

1072 X Ray Dr
Gastonia, NC 28054
Phone (704) 671-1094

315 19th St SE
Bldg 200
Hickory, NC 28602

315 19th St SE
Hickory, NC 28602
Phone (828) 325-9849

1927 3rd Avenue Ln SE
Hickory, NC 28602
Phone (828) 328-3500

315 19th St SE
Bldg 100
Hickory, NC 28602
Phone (828) 325-9849

Organizations & group practices 2

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.

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": "1552780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1518426865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1072 X RAY DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547488",
            "telephone_number": "980-399-6330",
            "fax_number": "704-671-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 19TH ST SE BLDG 100",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286024230",
            "telephone_number": "828-328-3500",
            "fax_number": "828-328-8777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11100 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441061716",
            "country_code": "US",
            "telephone_number": "216-844-4780",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1927 3rd Avenue Ln SE",
            "address_purpose": "LOCATION",
            "city": "Hickory",
            "state": "NC",
            "postal_code": "286022960",
            "country_code": "US",
            "telephone_number": "828-328-3500",
            "fax_number": "828-328-8777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORTENBERY",
        "first_name": "GREY",
        "middle_name": "WILSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-17",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NC",
            "license": "202501299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.