Individual provider Active NPI

Cecil Dwight Price, M.D.

  • Family Medicine Physician
  • Winston Salem, NC
National Provider Identifier
1730220963
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30846 Issued in NC
Practice address
Wake Forest University - 1834 Reynolda Road
Mackie Health Center - Reynolds Gymnasium - Wingate Rd
Winston Salem, NC 27106
Phone
(336) 758-5218
Fax
(336) 758-6054
NPI assigned
Feb 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 30846 NC Primary

Addresses

Primary practice location

Wake Forest University - 1834 Reynolda Road
Mackie Health Center - Reynolds Gymnasium - Wingate Rd
Winston Salem, NC 27106

Mailing address

PO Box 7386
Wake Forest University Student Health Service
Winston Salem, NC 27109-7386
Phone (336) 758-5218

Other identifiers 1

IdentifierTypeStateIssuer
30846OtherNCSTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30846NCMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1730220963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7386",
            "address_2": "WAKE FOREST UNIVERSITY STUDENT HEALTH SERVICE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271097386",
            "telephone_number": "336-758-5218",
            "fax_number": "336-758-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WAKE FOREST UNIVERSITY - 1834 REYNOLDA ROAD",
            "address_2": "MACKIE HEALTH CENTER - REYNOLDS GYMNASIUM - WINGATE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27106",
            "telephone_number": "336-758-5218",
            "fax_number": "336-758-6054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "CECIL",
        "middle_name": "DWIGHT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "30846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "30846",
            "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 Mar 7, 2023; 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.