Forsyth Memorial Hospital Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FORSYTH MEMORIAL HOSPITAL INC

Doing business as

Novant Health Yadkin Medical Associates

Practice address

305 E Lee Ave
Yadkinville, NC 27055-8132

Phone

(336) 679-2661

Fax

(336) 679-7056

NPI assigned

May 2, 2006

Last updated

Jul 12, 2023By 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

Leea Jeanine Walton

Title

RCS Manager

Phone

(704) 316-6081

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Novant Health Yadkin Medical Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

• Stephen G. Bissette, MD

  • Family Medicine Physician
  • Yadkinville, NC
  • NPI 1073592903
  NPD
• Marianthe Manak Burns, MD

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1952353708
  NPD
• Lauren Reavis Heller, FNP-BC

  • Nurse Practitioner
  • Yadkinville, NC
  • NPI 1336773217
  NPD
• Mary Kathryn Brewer Key

  • Family Medicine Physician
  • Yadkinville, NC
  • NPI 1801324686
  NPD
• Joann Taylor-Parris, MD

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1982621330
  NPD
• John Taylor Williams, MD

  • Family Medicine Physician
  • Yadkinville, NC
  • NPI 1073574604
  NPD

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689120000000",
    "number": "1730147588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-679-2661",
            "fax_number": "336-679-7056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E LEE AVE",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270558132",
            "telephone_number": "336-679-2661",
            "fax_number": "336-679-7056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORSYTH MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "LEEA",
        "authorized_official_middle_name": "JEANINE",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "704-316-6081"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA1315",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890296E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Yadkin Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Yadkin Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eckerd Corporation (Rite Aid Pharmacy 11318)
• Jerrold Max Evington
• Express Care of Yadkin
• Express Care of Yadkin LLC
• Vera Ellen Fitzgerald, MD
• Forsyth Memorial Hospital, Inc.
• Forsyth Memorial Hospital, Inc. (Novant Health Heart & Vascular Institute - Yadkinville)
• Brandon Taylor Gambill
• Lorrie Gammons, COTA
• Joy M Gaska, NP

• Family Medicine Physician in Yadkinville, NC
• Providers in Yadkinville, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.