Active NPI
Winecoff Family Practice PLLC
- Family Medicine Physician
- Concord, NC
National Provider Identifier
1770548745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 9701631
- Legal business name
- WINECOFF FAMILY PRACTICE PLLC
- Practice address
- 304 Winecoff School Rd
Concord, NC 28027 - Phone
- (704) 262-7901
- Fax
- (704) 262-7902
- NPI assigned
- Apr 20, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jan A Van Ravesteyn, MD
- Title
- Physician Owner
- Phone
- (704) 262-7901
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9701631 | NC | Primary |
Addresses
Primary practice location
304 Winecoff School Rd
Concord, NC 28027
Mailing address
304 Winecoff School Rd
Concord, NC 28027
Phone (704) 262-7901
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1208V | Other | NC | BCBS |
| 891208V | Medicaid | NC |
National Provider Directory
National Provider Directory- Tax ID family
- Novant Health Medical Group LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Family Medicine Physician
- Concord, NC
- NPI 1467600379
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Concord, NC
- NPI 1639119860
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145491200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1770548745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 WINECOFF SCHOOL RD",
"city": "CONCORD",
"state": "NC",
"postal_code": "28027",
"telephone_number": "704-262-7901",
"fax_number": "704-262-7902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 WINECOFF SCHOOL RD",
"city": "CONCORD",
"state": "NC",
"postal_code": "28027",
"telephone_number": "704-262-7901",
"fax_number": "704-262-7902"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WINECOFF FAMILY PRACTICE PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-20",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "VAN RAVESTEYN",
"authorized_official_first_name": "JAN",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "PHYSICIAN OWNER",
"authorized_official_telephone_number": "704-262-7901",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "NC",
"license": "9701631",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1208V",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891208V",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Concord, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.