David Ruddle Carr, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

34830 Issued in NC

Practice address

2825 Lyndhurst Ave Ste 101
Winston Salem, NC 27103-4146

Phone

(336) 277-6300

Fax

(336) 277-6309

NPI assigned

Mar 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1881654663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-765-5221",
            "fax_number": "704-765-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 LYNDHURST AVE STE 101",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034146",
            "telephone_number": "336-277-6300",
            "fax_number": "336-277-6309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2915 Lyndhurst Ave",
            "address_purpose": "LOCATION",
            "city": "Winston-Salem",
            "state": "NC",
            "postal_code": "271034005",
            "country_code": "US",
            "telephone_number": "336-765-5221",
            "fax_number": "336-765-0430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARR",
        "first_name": "DAVID",
        "middle_name": "RUDDLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2023-03-07",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "34830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8921291",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC LICENSE",
            "identifier": "34830",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dcarr19907@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2915 Lyndhurst Ave",
            "city": "Winston-Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271034005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Suzanne N Caroon, LCSW
• Jimmy Wayne Carpenter, C.PED
• Sahaja Mahathi Carpenter, MD
• Stephanie Allen Carpenter, RD
• Anne Kizer Carper, LCMHC
• Elizabeth Paige Carr
• Tanner Samuel Carr, DPM
• Vicki Deanne Carr, LPC
• David E Carraher
• Emma Hale Carraway

• Surgery Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.