Individual provider Active NPI

Diana E Lizardo-Morales, MD

  • Family Medicine Physician
  • Winston-Salem, NC
National Provider Identifier
1871541086
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Practice address
755 Highland Oaks Dr
Ste 202
Winston-Salem, NC 27103-7106
Phone
(336) 760-0070
Fax
(336) 760-0017
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NC Primary

Addresses

Primary practice location

755 Highland Oaks Dr
Ste 202
Winston-Salem, NC 27103-7106

Mailing address

755 Highland Oaks Dr
Ste 202
Winston-Salem, NC 27103-7106
Phone (336) 760-0070

Other identifiers 1

IdentifierTypeStateIssuer
1389UOtherNCBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200201384NCMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871541086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 HIGHLAND OAKS DR",
            "address_2": "STE 202",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271037106",
            "telephone_number": "336-760-0070",
            "fax_number": "336-760-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 HIGHLAND OAKS DR",
            "address_2": "STE 202",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271037106",
            "telephone_number": "336-760-0070",
            "fax_number": "336-760-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZARDO-MORALES",
        "first_name": "DIANA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1389U",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston-Salem, NC

Sources for this page

Verify at the official NPI Registry.