NPIMap

Individual provider Active NPI

Allston Julius Stubbs, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Winston Salem, NC
National Provider Identifier
1750354767
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
200201533 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone
(336) 716-2255
Fax
(336) 716-8018
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 200201533 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-0001

Mailing address

PO Box 344
Winston Salem, NC 27102-0344
Phone (336) 716-2255

Other identifiers 4

IdentifierTypeStateIssuer
5905396MedicaidNC
Q0153AMedicaidSC
5705050OtherNCAETNA
143KUOtherNCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070122000248 NC Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 4284607961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
Duke University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

1901 Mooney St
Winston Salem, NC 27103-3027
Phone (336) 716-8091

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200201533NCMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Feb 1, 2008 Accepting new patients
Steadman Clinic Professional LLC Sports Medicine Past Accepting new patients

Locations

1901 Mooney St
Winston Salem, NC 27103
Phone (336) 716-8091

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

185 Kimel Park Dr
Ste 201
Winston Salem, NC 27103
Phone (336) 760-9411

Interoperability endpoints

  • Direct secure messaging: astubbs2754376@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1750354767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 344",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271020344",
            "telephone_number": "336-716-2255",
            "fax_number": "336-716-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2255",
            "fax_number": "336-716-8018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUBBS",
        "first_name": "ALLSTON",
        "middle_name": "JULIUS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NC",
            "license": "200201533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905396",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q0153A",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5705050",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "143KU",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.