Wake Forest University Baptist Medical Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER

Doing business as

Wilkes Family Health Center

Practice address

1534 West D St
North Wilkesboro, NC 28659-3528

Phone

(336) 667-4178

Fax

(336) 667-0938

NPI assigned

Feb 21, 2007

Organization subpart

Yes

Parent organization

WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANSAs reported in NPPES

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

Authorized official

Name

Mr. Lewis S Thorp III

Title

President Ceo

Phone

(336) 721-3900

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Wilkes Family Health Center Doing business as

Part of

Peace Haven Urgent Care

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Wake Forest University Baptist Medical Center Community Physicians

  dba Young Family Practice

  • Family Medicine Physician
  • Statesville, NC
  • NPI 1417940636
  NPPES parent name

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207872000000",
    "number": "1770628208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1534 WEST D ST",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593528",
            "telephone_number": "336-667-4178",
            "fax_number": "336-667-0938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1534 WEST D ST",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593528",
            "telephone_number": "336-667-4178",
            "fax_number": "336-667-0938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-04-11",
        "status": "A",
        "authorized_official_last_name": "THORP",
        "authorized_official_first_name": "LEWIS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "336-721-3900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "2317728S",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906393",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilkes Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Veins Limited, PLLC (Vein Centers for Excellence of Wilkesboro)
• Valerie B Vickers-Robinson, LPC
• Keara Vincent, DDS
• Mark Wages
• Wake Forest Baptist Health Care at Home, LLC (Wake Forest Bapatist Healthcare a Home, Community Care-Wilkes, Disable)
• Wake Forest University Baptist Medical Center Community Physicians (Wilkesboro Internal Medicine)
• Wake Forest University Baptist Medical Center Community Physicians (Northwest Digestive Health)
• Wake Forest University Health Sciences
• Wake Forest University Health Sciences
• Wake Forest University Health Sciences

• Family Medicine Physician in North Wilkesboro, NC
• Providers in North Wilkesboro, 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 Apr 11, 2008; 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.