NPIMap

Individual provider Active NPI

Jason W Caldwell, DO

  • Allergy & Immunology Physician
  • Winston Salem, NC
National Provider Identifier
1548441702
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
2009-01500 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157
Phone
(336) 716-2255
NPI assigned
Nov 16, 2007
Last updated
Jun 25, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 2009-01500 NC Primary
Allergy & Immunology (Internal Medicine) Physician 207RA0201X 2009-01500 NC
Pediatrics Physician 208000000X OS9850 FL

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157

Mailing address

PO Box 602658
Charlotte, NC 28260-2658
Phone (336) 716-2255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091008000471 NC Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 9436295243 Reassigns benefits to 1 organization
I20241003002522 SC Practitioner - Allergy/ImmunologyPractitioner - Pulmonary DiseasePractitioner - Pediatric Medicine 9436295243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Pediatric Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS9850FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol CurrentSince Sep 1, 2024 Accepting new patients
Wake Forest Health Network, LLC Pediatrics CurrentSince Apr 1, 2018 Accepting new patients
Wake Forest Health Network LLC Pediatrics Current Accepting new patients
Wake Forest Health Network LLC CurrentSince Apr 1, 2018 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Sep 1, 2024 Accepting new patients

Locations

680 Parkwood Medical Park
Elkin, NC 28621
Phone (336) 527-8359

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

1401 Old Mill Cir
Ste A
Winston Salem, NC 27103
Phone (336) 768-0914

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

Interoperability endpoints

  • Direct secure messaging: jcaldwell502826@direct.musc.edu

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 6

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": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1548441702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602658",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602658",
            "telephone_number": "336-716-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27157",
            "telephone_number": "336-716-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "JASON",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-16",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NC",
            "license": "2009-01500",
            "primary": true
        },
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "NC",
            "license": "2009-01500",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS9850",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.