Active NPI
Myron Sheavictor Powell, M.D.
- Surgery Physician
- Winston Salem, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 2012-01042
- Practice address
- Medical Center Blvd
Winston Salem, NC 27157-0001 - Phone
- (336) 716-2255
- Fax
- (336) 716-6637
- NPI assigned
- Jan 2, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 2012-01042 | NC | Primary |
Addresses
Primary practice location
Medical Center Blvd
Winston Salem, NC 27157-0001
Mailing address
PO Box 602658
Charlotte, NC 28260-2658
Phone (336) 716-2255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5920407 | Medicaid | NC |
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
- General Surgery
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3903 N Elm St
Greensboro, NC 27455-2594
Phone (336) 713-4944
4610 Country Club Rd
Winston Salem, NC 27104-3520
Phone (336) 716-2255
4614 Country Club Rd
Winston Salem, NC 27104-3520
Phone (336) 716-2255
4618 Country Club Rd
Winston Salem, NC 27104-3520
Phone (336) 716-3926
Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734
Hospital & facility affiliations
- North Carolina Baptist Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012-01042 | NC | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wake Forest University Health Sciences | Current | Accepting new patients |
Locations
10 Medical Park Dr
Lexington, NC 27292
Phone (336) 236-4681
Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Winston Salem, NC
- NPI 1003803032
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Winston Salem, NC
- NPI 1063480531
-
- Rehabilitation Hospital Unit
- Winston Salem, NC
- NPI 1114995677
-
- General Acute Care Hospital
- Winston Salem, NC
- NPI 1144211301
-
- Clinical Medical Laboratory
- Winston Salem, NC
- NPI 1609162098
Hospital
-
- Pediatric Adolescent Medicine Physician
- Winston Salem, NC
- NPI 1912179219
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359331200000",
"number": "1881879484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 602658",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282602658",
"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": "336-716-2255",
"fax_number": "336-716-6637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWELL",
"first_name": "MYRON",
"middle_name": "SHEAVICTOR",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-02",
"last_updated": "2013-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NC",
"license": "2012-01042",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5920407",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
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 Jan 28, 2013; 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.