Individual provider Active NPI

J. Taylor Bellamy, MD

  • Orthopaedic Surgery Physician
  • Winston Salem, NC
National Provider Identifier
1578069720
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
2024-01272 Issued in NC
Practice address
180 Kimel Park Dr
Winston Salem, NC 27103-6976
Phone
(336) 659-3700
Fax
(336) 765-6375
NPI assigned
Apr 4, 2018
Last updated
Aug 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2024-01272 NC Primary
Orthopaedic Surgery Physician 207X00000X 1013151 MA

Addresses

Primary practice location

180 Kimel Park Dr
Winston Salem, NC 27103-6976

Mailing address

4601 Park Rd Ste 300
Charlotte, NC 28209-2290
Phone (704) 323-2248

Other practice location 1

3311 Jessie Village Dr
Clemmons, NC 27012-9963
Phone (336) 659-4135

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
I20240825000037 NC Practitioner - Orthopedic Surgery 9830440031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Emory University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
OrthocarolinaGroup PAC ID 2062316821, 288 clinicians

Practice addresses (Care Compare)

120 Charlois Blvd
Winston Salem, NC 27103-1562
Phone (336) 765-5664

180 Kimel Park Dr
Winston Salem, NC 27103-6976
Phone (704) 323-2276

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion44
Laminectomy or laminotomy (partial removal of spine bones)17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1013151MAMDOrthopaedic Surgery Physician
2024-01272NCMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Jul 28, 2023 Accepting new patients
Brigham & Womens Physicians Organization Inc Orthopaedic Surgery CurrentSince Jul 28, 2023 Accepting new patients
Orthocarolina Orthopaedic Surgery CurrentSince Aug 6, 2024 Accepting new patients
Orthocarolina Orthopaedic Surgery Current Accepting new patients
Orthocarolina Orthopaedic Surgery CurrentSince Aug 6, 2024 Accepting new patients
Massachusetts General Physicians Organization Inc Orthopaedic Surgery CurrentSince Jul 28, 2023 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

75 Francis St
Boston, MA 02115

1915 Randolph Rd
Charlotte, NC 28207
Phone (704) 339-1000

4601 Park Rd
Ste 300
Charlotte, NC 28209
Phone (704) 323-2090

3311 Jessie Village Dr
Clemmons, NC 27012
Phone (336) 659-4135

180 Kimel Park Dr
Winston Salem, NC 27103
Phone (336) 277-1700

Organizations & group practices 6

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 4

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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1578069720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092290",
            "telephone_number": "704-323-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 KIMEL PARK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036976",
            "telephone_number": "336-659-3700",
            "fax_number": "336-765-6375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3311 Jessie Village Dr",
            "address_purpose": "LOCATION",
            "city": "Clemmons",
            "state": "NC",
            "postal_code": "270129963",
            "country_code": "US",
            "telephone_number": "336-659-4135",
            "fax_number": "336-346-2150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELLAMY",
        "first_name": "J.",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2024-01272",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MA",
            "license": "1013151",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.