Forsyth Plastic Surgical Assoc PA

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

20000119979 Issued in NC

Legal business name

FORSYTH PLASTIC SURGICAL ASSOC PA

Practice address

2901 Maplewood Ave
Winston Salem, NC 27103

Phone

(336) 765-8620

Fax

(336) 768-6236

NPI assigned

Sep 7, 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

Dr. John Anduson Fagg, MDNPI 1316905508

Title

President

Phone

(336) 765-8620

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 5

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.

• Leslie Grace Branch, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Winston Salem, NC
  • NPI 1760777932
  Medicare reassignment Care Compare group NPD
• John Anderson Fagg, MD

  • Plastic Surgery Physician
  • Winston Salem, NC
  • NPI 1316905508
  Medicare reassignment NPD Authorized official
• Gilson John Kingman, MD

  • Otolaryngology/Facial Plastic Surgery Physician
  • Winston Salem, NC
  • NPI 1578504726
  Medicare reassignment Care Compare group NPD
• George Asbury Lawson III, MD

  • Plastic Surgery Physician
  • Winston Salem, NC
  • NPI 1225185010
  Medicare reassignment Care Compare group NPD
• Andrew Mark Schneider, M

  • Plastic Surgery Physician
  • Winston Salem, NC
  • NPI 1235170333
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811090475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 MAPLEWOOD AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-765-8620",
            "fax_number": "336-768-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 MAPLEWOOD AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-765-8620",
            "fax_number": "336-768-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORSYTH PLASTIC SURGICAL ASSOC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FAGG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ANDUSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-765-8620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NC",
            "license": "200001225739",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NC",
            "license": "200001205450",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NC",
            "license": "20000119979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Forsyth Memorial Hospital, Inc.
• Forsyth Memorial Hospital, Inc. (Novant Health Heart & Vascular Institute - Frontis Plaza)
• Forsyth Memorial Hospital, Inc.
• Forsyth Memorial Hospital, Inc. (CRNA Forsyth)
• Forsyth Memorial Hosptial Inc (Novant Health Carolinas Pelvic Health Center)
• Forsyth Radilogical Associates (Maplewood Imaging Center)
• Forsyth Radiological Associates (Greystone Imaging Center)
• Forsyth Radiological Associates
• Forsyth Surgical Associates
• Forsyth Transportation Services

• Plastic Surgery Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Plastic Surgery Physician 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.
• 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.