Forsyth Village

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-034-002 Issued in NC

Legal business name

FORSYTH VILLAGE

Practice address

5100 Lansing Dr
Winston Salem, NC 27105-3115

Phone

(336) 661-0850

Fax

(336) 661-0945

NPI assigned

Dec 28, 2006

Last updated

Aug 22, 2020By 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. Jerry Chapman

Title

Owner

Phone

(336) 661-0850

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801952643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11525",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271161525",
            "telephone_number": "336-661-0850",
            "fax_number": "336-661-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 LANSING DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271053115",
            "telephone_number": "336-661-0850",
            "fax_number": "336-661-0945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORSYTH VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-661-0850",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-034-002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804769",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Forsyth Radilogical Associates (Maplewood Imaging Center)
• Forsyth Radiological Associates (Greystone Imaging Center)
• Forsyth Radiological Associates
• Forsyth Surgical Associates
• Forsyth Transportation Services
• Forsythe Memorial Hospital, Inc (Maplewood Family Practice At the Village)
• O'Shane Lemar Forsythe
• Leslie Fort-Barrie, M.D.
• Christopher John Fort, M.D.
• Fortitude Counseling Services

• Assisted Living Facility in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Assisted Living Facility in North Carolina

• 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.

Verify at the official NPI Registry.