Organization Active NPI

Epilepsy Institute of NC

  • Neurology Physician
  • Winston Salem, NC
National Provider Identifier
1710929088
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
31945 Issued in NC
Legal business name
EPILEPSY INSTITUTE OF NC
Practice address
1311 Westbrook Plaza Dr
Suite 100
Winston Salem, NC 27103-1327
Phone
(336) 659-8202
Fax
(336) 659-8206
NPI assigned
Jun 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Joan Christine Dean, MDNPI 1902832850
Title
President
Phone
(336) 659-8202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 31945 NC Primary

Addresses

Primary practice location

1311 Westbrook Plaza Dr
Suite 100
Winston Salem, NC 27103-1327

Mailing address

1311 Westbrook Plaza Dr
Suite 100
Winston Salem, NC 27103-1327
Phone (336) 659-8202

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040629001686 NC Part B Supplier - Clinic/Group Practice 1951387836 Receives reassigned benefits from 1 practitioner
Practice locations: Winston Salem, NC

National Provider Directory

National Provider Directory

Locations

128 Peachtree Ln
Ste C
Advance, NC 27006

1311 Westbrook Plaza Dr
#100
Winston Salem, NC 27103
Phone (336) 659-8202

3726 Vest Mill Rd
Winston Salem, NC 27103

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710929088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 WESTBROOK PLAZA DR",
            "address_2": "SUITE 100",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031327",
            "telephone_number": "336-659-8202",
            "fax_number": "336-659-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 WESTBROOK PLAZA DR",
            "address_2": "SUITE 100",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031327",
            "telephone_number": "336-659-8202",
            "fax_number": "336-659-8206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPILEPSY INSTITUTE OF NC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "CHRISTINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-659-8202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "31945",
            "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 Aug 22, 2020; 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.