WP-Winston-Salem Health Holdings, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

WP-WINSTON-SALEM HEALTH HOLDINGS, LLC

Doing business as

Magnolia Creek Assisted Living

Practice address

2560 Willard Rd
Winston Salem, NC 27107-5543

Phone

(336) 650-0699

Fax

(336) 650-0132

NPI assigned

Dec 27, 2012

Last updated

Oct 26, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles E Trefzger

Title

Manager

Phone

(828) 322-5535

Specialties & licenses 3

Addresses

Other names 1

• Magnolia Creek Assisted Living Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1699011361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2568",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286032568",
            "telephone_number": "828-322-5535",
            "fax_number": "828-326-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 WILLARD RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271075543",
            "telephone_number": "336-650-0699",
            "fax_number": "336-650-0132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WP-WINSTON-SALEM HEALTH HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-27",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "TREFZGER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "828-322-5535"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-034-097",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Creek Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Magnolia Creek Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amber Faith Worthington
• Amy Elise Wortkoetter, PHARMD
• Joseph Daniel Wortman
• Paul Douglass Wortman, M.D.
• Wayne Joseph Wortmann III, MD
• Jillian Diane Wray, O.T.
• Walter Harrill Wray III, M.D.
• Ashley Marie Wren, LMBT
• Kathleen R. Wren, CRNA
• Wright and Associates VIII DDS PA

• Adult Care Home Facility in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.