Individual provider Active NPI

Edwin Andrew Stevens, M.D.

  • Neurological Surgery Physician
  • Clemmons, NC
National Provider Identifier
1700066321
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
2018-00142 Issued in NC
Practice address
2341 Lewisville Clemmons Rd
Clemmons, NC 27012-8905
Phone
(336) 713-2121
Fax
(336) 716-3065
NPI assigned
Nov 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 063741 GA
Neurological Surgery Physician 207T00000X 2018-00142 NC Primary

Addresses

Primary practice location

2341 Lewisville Clemmons Rd
Clemmons, NC 27012-8905

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 716-2255

Other identifiers 5

IdentifierTypeStateIssuer
767372981BMedicaidGA
767372981AMedicaidGA
767372981CMedicaidGA
1700066321MedicaidNC
767372981DMedicaidGA

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
I20180423000804 NC Practitioner - Neurosurgery 5092846139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Medical College of Georgia School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

2341 Lewisville Clemmons Rd
Clemmons, NC 27012-8905
Phone (336) 716-2255

Hospital & facility affiliations

  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion141
Laminectomy or laminotomy (partial removal of spine bones)29

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Feb 12, 2018 Accepting new patients
North Carolina Baptist Hospital PastSince Feb 12, 2018 Accepting new patients

Locations

329 NC Highway 801 N
Bermuda Run, NC 27006
Phone (336) 716-8200

2341 Lewisville Clemmons Rd
Fl 2
Clemmons, NC 27012
Phone (336) 716-4039

2341 Lewisville Clemmons Rd
Clemmons, NC 27012
Phone (336) 713-2121

404 Westwood Ave
Ste 201
High Point, NC 27262
Phone (336) 884-1800

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

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1194825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1700066321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-716-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2341 LEWISVILLE CLEMMONS RD",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128905",
            "telephone_number": "336-713-2121",
            "fax_number": "336-716-3065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "EDWIN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-12",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "GA",
            "license": "063741",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NC",
            "license": "2018-00142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767372981B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767372981A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767372981C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700066321",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767372981D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemmons, NC

Sources for this page

Verify at the official NPI Registry.