NPIMap

Organization Active NPI

The Shalom Project, Inc.

Doing business as The Shalon Project Medical Clinic

  • Community Health Clinic/Center
  • Winston Salem, NC
National Provider Identifier
1558104505
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
THE SHALOM PROJECT, INC.
Doing business as
The Shalon Project Medical Clinic
Practice address
3185 Maplewood Ave
Winston-Salem, NC 27103
Phone
(336) 721-0606
Fax
(866) 838-2811
NPI assigned
Jun 17, 2024
Last updated
Jun 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Authorized official

Name
Jeffrey Foster
Title
Programs Director
Phone
(336) 721-0606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X NU Primary

Addresses

Primary practice location

3185 Maplewood Ave
Winston-Salem, NC 27103

Mailing address

639 S Green St
Winston-Salem, NC 27101
Phone (336) 721-0606

Other names 1

  • The Shalon Project Medical Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
The Shalom Project Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

639 S Green St
Winston Salem, NC 27101
Phone (336) 721-0606

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1558104505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 S GREEN ST",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27101",
            "telephone_number": "336-721-0606",
            "fax_number": "866-838-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3185 MAPLEWOOD AVE",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-721-0606",
            "fax_number": "866-838-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SHALOM PROJECT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PROGRAMS DIRECTOR",
        "authorized_official_telephone_number": "336-721-0606"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Shalon Project Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.