NPIMap

Organization Active NPI

Wellspring Family Medicine, PA

  • Family Medicine Physician
  • Walnut Cove, NC
National Provider Identifier
1871745166
Registry record updated Apr 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WELLSPRING FAMILY MEDICINE, PA
Practice address
701 North Main Street
Walnut Cove, NC 27052-9346
Phone
(336) 508-9565
NPI assigned
Oct 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2009

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

Authorized official

Name
Mr. Sterling T Wooten
Title
Consultant
Phone
(336) 972-3566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

701 North Main Street
Walnut Cove, NC 27052-9346

Mailing address

701 North Main Street
Walnut Cove, NC 27052-9346

National Provider Directory

National Provider Directory

Locations

701 N Main St
Walnut Cove, NC 27052
Phone (336) 508-9565

NPI Registry JSON

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

{
    "created_epoch": "1224201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239753600000",
    "number": "1871745166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 NORTH MAIN STREET",
            "city": "WALNUT COVE",
            "state": "NC",
            "postal_code": "270529346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 NORTH MAIN STREET",
            "city": "WALNUT COVE",
            "state": "NC",
            "postal_code": "270529346",
            "telephone_number": "336-508-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING FAMILY MEDICINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-17",
        "last_updated": "2009-04-15",
        "status": "A",
        "authorized_official_last_name": "WOOTEN",
        "authorized_official_first_name": "STERLING",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CONSULTANT",
        "authorized_official_telephone_number": "336-972-3566",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Cove, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2009; 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.