NPIMap

Organization Active NPI

Forsyth Medical Group LLC

Doing business as Queen City Ear Nose and Throat

  • Otolaryngology Physician
  • Monroe, NC
National Provider Identifier
1710866405
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
FORSYTH MEDICAL GROUP LLC
Doing business as
Queen City Ear Nose and Throat
Practice address
1994 Wellness Blvd Ste 210
Monroe, NC 28110-7768
Phone
(704) 703-1080
Fax
(704) 703-1090
NPI assigned
Aug 28, 2025
Last updated
Aug 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Authorized official

Name
Jody Morris
Title
VP Ops and New Development
Phone
(919) 497-8401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X Primary

Addresses

Primary practice location

1994 Wellness Blvd Ste 210
Monroe, NC 28110-7768

Mailing address

2085 Frontis Plaza Blvd FL 3
Winston Salem, NC 27103-5614
Phone (336) 277-1611

Other names 1

  • Queen City Ear Nose and Throat Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031201000123 NC Part B Supplier - Clinic/Group Practice 3678478054 Receives reassigned benefits from 55 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Wilmington, NC; Randleman, NC; Raleigh, NC; Monroe, NC; Matthews, NC; Jamestown, NC; Huntersville, NC; Hickory, NC…

National Provider Directory

National Provider Directory
Tax ID family
Forsyth Medical Group LLC28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Locations

610 N Fayetteville St
Ste 300
Asheboro, NC 27203
Phone (336) 633-4020

7006 Shannon Willow Rd
Ste A
Charlotte, NC 28226
Phone (980) 960-0526

269 Gillman Rd
Ste 200
Denver, NC 28037
Phone (704) 316-1150

3120 Randleman Rd
Greensboro, NC 27406

3711 Battleground Ave
Greensboro, NC 27410

4835 W Wendover Ave
Jamestown, NC 27282

280 Broad St
Ste D
Kernersville, NC 27284
Phone (336) 718-7470

434 N Trade St
Ste 104
Matthews, NC 28105
Phone (704) 246-3936

180 Kimel Park Dr
Ste 110
Winston Salem, NC 27103
Phone (336) 277-1700

1900 S Hawthorne Rd
#480
Winston Salem, NC 27103
Phone (336) 277-1655

225 Charlois Blvd
Winston Salem, NC 27103

Practitioners & affiliated clinicians

Practitioners 53

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1756339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756339200000",
    "number": "1710866405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 FRONTIS PLAZA BLVD FL 3",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035614",
            "telephone_number": "336-277-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1994 WELLNESS BLVD STE 210",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281107768",
            "telephone_number": "704-703-1080",
            "fax_number": "704-703-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORSYTH MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-28",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "JODY",
        "authorized_official_title_or_position": "VP OPS AND NEW DEVELOPMENT",
        "authorized_official_telephone_number": "919-497-8401"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Queen City Ear Nose and Throat",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monroe, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.