NPIMap

Organization Active NPI

Dedicated Physicians Group of North Carolina PLLC

Doing business as Dedicated Senior Medical Center Southside Winston Salem TC

  • Non-Pharmacy Dispensing Site
  • Winston Salem, NC
National Provider Identifier
1811622137
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
DEDICATED PHYSICIANS GROUP OF NORTH CAROLINA PLLC
Doing business as
Dedicated Senior Medical Center Southside Winston Salem TC
Practice address
7830 N Point Blvd
Winston Salem, NC 27106-3261
Phone
(743) 223-3400
Fax
(743) 223-3226
NPI assigned
Jul 20, 2022
Last updated
Jul 20, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
DEDICATED PHYSICIANS GROUP OF NORTH CAROLINA PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Mary Chen
Title
Authorized Official
Phone
(305) 628-6117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X NU Primary

Addresses

Primary practice location

7830 N Point Blvd
Winston Salem, NC 27106-3261

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (305) 628-6117

Other names 1

  • Dedicated Senior Medical Center Southside Winston Salem TC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dedicated Physicians Group of North Carolina PLLC8 organizations share this tax ID, including this one
Part of
Dedicated Physicians Group of North Carolina PLLC

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7830 N Point Blvd
Winston Salem, NC 27106
Phone (743) 223-3400

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1811622137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7830 N POINT BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063261",
            "telephone_number": "743-223-3400",
            "fax_number": "743-223-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEDICATED PHYSICIANS GROUP OF NORTH CAROLINA PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEDICATED PHYSICIANS GROUP OF NORTH CAROLINA PLLC",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "305-628-6117"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dedicated Senior Medical Center Southside Winston Salem TC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.