Active NPI
Fulfilled Iwosa Ighalo, MD
- Pediatric Endocrinology Physician
- Winston Salem, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Endocrinology Physician
- License
- 2025-00948
- Practice address
- Medical Center Blvd
Winston Salem, NC 27157-0001 - Phone
- (336) 713-4500
- Fax
- (336) 713-4501
- NPI assigned
- Jun 24, 2019
- Last updated
- Nov 13, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 313269 | LA | |
| Pediatric Endocrinology Physician | 2080P0205X | 2025-00948 | NC | Primary |
Addresses
Primary practice location
Medical Center Blvd
Winston Salem, NC 27157-0001
Mailing address
100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 716-2255
Other practice location 1
4700 S I 10 Service Rd W
Metairie, LA 70001-1269
Phone (504) 780-8282
Other practice location 2
200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone (504) 899-9511
Other practice location 3
1 Baylor Plz
Houston, TX 77030-3411
Phone (832) 822-3670
Other practice location 4
1514 Jefferson Hwy
Jefferson, LA 70121-2429
Phone (886) 624-7637
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
100 Kimel Forest Dr
Winston Salem, NC 27103-6074
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2025-00948 | NC | MD | Pediatric Endocrinology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wake Forest University Health Sciences | Current | Accepting new patients |
Locations
100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947
4610 Country Club Rd
Winston Salem, NC 27104
Phone (336) 713-3325
Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697
Interoperability endpoints
- fighalo3025676@carolinashealthcaresystem.direct-ci.com
- fighalo417491@prddirect.texaschildrens.org
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Winston Salem, NC
- NPI 1003803032
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762992000000",
"number": "1811558539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 KIMEL FOREST DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271036074",
"telephone_number": "336-716-2255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MEDICAL CENTER BLVD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271570001",
"telephone_number": "336-713-4500",
"fax_number": "336-713-4501"
}
],
"practiceLocations": [
{
"address_1": "4700 S I 10 Service Rd W",
"address_purpose": "LOCATION",
"city": "Metairie",
"state": "LA",
"postal_code": "700011269",
"country_code": "US",
"telephone_number": "504-780-8282",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "200 Henry Clay Ave",
"address_purpose": "LOCATION",
"city": "New Orleans",
"state": "LA",
"postal_code": "701185720",
"country_code": "US",
"telephone_number": "504-899-9511",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Baylor Plz",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770303411",
"country_code": "US",
"telephone_number": "832-822-3670",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1514 Jefferson Hwy",
"address_purpose": "LOCATION",
"city": "Jefferson",
"state": "LA",
"postal_code": "701212429",
"country_code": "US",
"telephone_number": "886-624-7637",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "IGHALO",
"first_name": "FULFILLED",
"middle_name": "IWOSA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-24",
"last_updated": "2025-11-13",
"certification_date": "2025-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "LA",
"license": "313269",
"primary": false
},
{
"code": "2080P0205X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Endocrinology",
"state": "NC",
"license": "2025-00948",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Winston Salem, NC
- Janet Lenora Idol, FNP-C
- Oreoluwa Idowu
- Itohan Igbinigie, MA, CCC-SLP
- Theodore Osarumwense Igbinigie, MD
- Chioma Igboegwu, PHD, LCAS-A
- Emmanuelar Onyinyechukwu Igweonu-Nwakile, MD
- Obinna Ikwechegh, MD
- Adebola Omolara Ilesanmi, FNP
- Illumii
- Imani Enterprises Dba a L Nursing Home Care Agency (AL Nursing Home Care Agency)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.