Active NPI
Suzy Gibson Lorentz, NP
- Nurse Practitioner
- Winston Salem, NC
National Provider Identifier
1659346187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 72176
- Practice address
- 1351 Westgate Center Dr
Dba Forsyth Pediatric Associates - Westgate
Winston Salem, NC 27103-2934 - Phone
- (336) 718-7777
- Fax
- (336) 718-7757
- NPI assigned
- Feb 20, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 72176 | NC | Primary |
Addresses
Primary practice location
1351 Westgate Center Dr
Dba Forsyth Pediatric Associates - Westgate
Winston Salem, NC 27103-2934
Mailing address
2000 Frontis Plaza Blvd Ste 200
(Attn) Forsyth Medical Group
Winston Salem, NC 27103-5616
Phone (336) 277-2435
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)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 72176 | NC | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659346187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 FRONTIS PLAZA BLVD STE 200",
"address_2": "(ATTN) FORSYTH MEDICAL GROUP",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271035616",
"telephone_number": "336-277-2435",
"fax_number": "336-277-9275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1351 WESTGATE CENTER DR",
"address_2": "DBA FORSYTH PEDIATRIC ASSOCIATES - WESTGATE",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271032934",
"telephone_number": "336-718-7777",
"fax_number": "336-718-7757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LORENTZ",
"first_name": "SUZY",
"middle_name": "GIBSON",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "72176",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.