Orthocarolina

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

38865 Issued in NC

Legal business name

ORTHOCAROLINA

Practice address

170 Kimel Park Dr
Winston Salem, NC 27103-6946

Phone

(704) 323-2000

NPI assigned

Mar 11, 2014

Last updated

Sep 9, 2026By 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

Mr. Brent Shear

Title

Cfo

Phone

(704) 323-2000

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 7

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.

• Alexander Warren Coates, FNP

  • Family Nurse Practitioner
  • Winston Salem, NC
  • NPI 1982574364
  NPD
• Dana Dempsey Cumberworth, PA-C

  • Physician Assistant
  • Charlotte, NC
  • NPI 1568727113
  NPD
• Philip Maximilian Dayvault, PA

  • Physician Assistant
  • Salisbury, NC
  • NPI 1003053935
  NPD
• John Kent Ellington, MD, MS

  • Orthopaedic Surgery Physician
  • Charlotte, NC
  • NPI 1588795215
  NPD
• Sara Frances Garcia

  • Physician Assistant
  • Charlotte, NC
  • NPI 1578057964
  NPD
• Christopher Ryan Moore, PT

  • Physical Therapist
  • Matthews, NC
  • NPI 1609390392
  NPD
• Caroline Anne Sidwell, PA-C

  • Physician Assistant
  • Concord, NC
  • NPI 1144938218
  NPD

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

{
    "created_epoch": "1394496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1790101004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092290",
            "telephone_number": "704-323-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 KIMEL PARK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036946",
            "telephone_number": "704-323-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOCAROLINA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-11",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "SHEAR",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "704-323-2000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "38865",
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "NC",
            "license": "38865",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "NC",
            "license": "38865",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NC",
            "license": "38865",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "NC",
            "license": "38865",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NC",
            "license": "38865",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "NC",
            "license": "38865",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liston Orr, MD
• Virginia D. Orr
• William Frank Orrell III, LCMHCA
• Laura Montgomery Orsban, PA
• Victor Enrique Ortega, M.D.
• Orthocarolina
• Orthopaedic Specialists of the Carolinas, P.a.
• Orthopaedic Specialists of the Carolinas, P.a.
• Ilia Raquel Ortiz
• Alisa Boyette Ortman, RPH

• Orthopaedic Surgery Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Orthopaedic Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.