Active NPI
Matthew G Hough, DO
- Child & Adolescent Psychiatry Physician
- Winston Salem, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 200301472
- Practice address
- 791 Jonestown Rd
Winston Salem, NC 27103-1252 - Phone
- (336) 716-4551
- NPI assigned
- Dec 2, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 200301472 | NC | Primary |
Addresses
Primary practice location
791 Jonestown Rd
Winston Salem, NC 27103-1252
Mailing address
PO Box 602658
Charlotte, NC 28260-2658
Phone (336) 716-2011
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89135XF | Medicaid | NC | |
| 2007390000 | Medicaid | WV | |
| D1523 | Other | NC | MEDCOST |
| 803863 | Other | NC | PARTNERS |
| 7655636 | Other | AETNA | |
| 10069131 | Medicaid | VA | |
| 135XF | Other | NC | BCBS |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Des Moines University of Osteopathic Medicine and Health Sciences, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
791 Jonestown Rd
WFBH Psychiatry Jonestown
Winston-Salem, NC 27103-1252
Phone (336) 716-2255
Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wake Forest University Health Sciences | Current | Accepting new patients |
Locations
250 Hospital Dr
Lexington, NC 27292
Phone (336) 238-4150
791 Jonestown Rd
Winston Salem, NC 27103
Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697
100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947
Interoperability endpoints
- mhough2754041@carolinashealthcaresystem.direct-ci.com
- mhough248982@direct.ochin.org
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Winston Salem, NC
- NPI 1003803032
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441238400000",
"number": "1700860772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 602658",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282602658",
"telephone_number": "336-716-2011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "791 JONESTOWN RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271031252",
"telephone_number": "336-716-4551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOUGH",
"first_name": "MATTHEW",
"middle_name": "G",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-02",
"last_updated": "2015-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NC",
"license": "200301472",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89135XF",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2007390000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "D1523",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS",
"identifier": "803863",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7655636",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10069131",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "135XF",
"state": "NC"
}
],
"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 Sep 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.