Wilkes ENT& Audiology, PLLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

WILKES ENT& AUDIOLOGY, PLLC

Doing business as

Mt. Airy ENT-Head & Neck Surgery Audiology

Practice address

708 S South St Ste 300
Mount Airy, NC 27030-4589

Phone

(336) 838-7758

Fax

(336) 838-7758

NPI assigned

May 31, 2006

Last updated

Jan 6, 2020By 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

Dr. M Barry Ellis, MD

Title

Owner Doctor

Phone

(336) 673-3125

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Mt. Airy ENT-Head & Neck Surgery Audiology Doing business as

Locations

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578268800000",
    "number": "1720025851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 S SOUTH ST STE 300",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270304589",
            "telephone_number": "336-673-3125",
            "fax_number": "336-838-9790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 S SOUTH ST STE 300",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270304589",
            "telephone_number": "336-838-7758",
            "fax_number": "336-838-7758"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1915 W Park Dr",
            "address_2": "Suite 107",
            "address_purpose": "LOCATION",
            "city": "North Wilkesboro",
            "state": "NC",
            "postal_code": "286593511",
            "country_code": "US",
            "telephone_number": "336-838-7758",
            "fax_number": "336-838-9790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WILKES ENT& AUDIOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "M",
        "authorized_official_middle_name": "BARRY",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "336-673-3125",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC6285",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890115W",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mt. Airy ENT-Head & Neck Surgery Audiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sandra Brown White, RPH
• Nina Y Whitley, OTRL
• Whitney Smith Christian Counseling & Consulting, PLLC
• Andrew James Wick
• Lynnessa Robyn Widelo, NP
• Daniel Lee Wilkes, DPM
• Meghan C Wilkie
• William L Barham DDS PA
• Abigail Grace Williams
• Robert Van Williamson, M.D.

• Otolaryngology Physician in Mount Airy, NC
• Providers in Mount Airy, NC by specialty
• Otolaryngology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.