Individual provider Active NPI

Elizabeth Rose Scannell, MD

  • Allergy & Immunology Physician
  • Winston Salem, NC
National Provider Identifier
1952369571
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
200200597 Issued in NC
Practice address
1372 Westgate Center Dr
Winston Salem, NC 27103-2932
Phone
(336) 659-4814
Fax
(336) 768-4745
NPI assigned
May 3, 2006
Last updated
Oct 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 200200597 NC Primary

Addresses

Primary practice location

1372 Westgate Center Dr
Winston Salem, NC 27103-2932

Mailing address

PO Box 603725
Charlotte, NC 28260-3725
Phone (828) 575-2625

Other identifiers 3

IdentifierTypeStateIssuer
1952369571MedicaidVA
1952369571MedicaidNC
2033561AOtherNCMEDICARE PTAN

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041022000114 NC Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 0648231761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Rush Medical College of Rush University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergy Partners PLLCGroup PAC ID 7113822420, 144 clinicians

Practice addresses (Care Compare)

1372 Westgate Ctr Dr
Winston Salem, NC 27103-2932
Phone (336) 659-4814

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200200597NCMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Partners, PLLC Allergy & Immunology CurrentSince Apr 1, 2007 Accepting new patients
NPI 1508468638 Allergy & Immunology CurrentSince Apr 1, 2007 Accepting new patients
Allergy Partners, PLLC Allergy & Immunology Current Accepting new patients

Locations

851 Old Winston Rd
Ste 103
Kernersville, NC 27284
Phone (336) 993-9995

911 Worth St
Mount Airy, NC 27030
Phone (336) 786-8880

116 Wilkesboro Ave
Ste C
North Wilkesboro, NC 28659
Phone (336) 667-6193

1372 Westgate Center Dr
Winston Salem, NC 27103
Phone (336) 659-4814

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1952369571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603725",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603725",
            "telephone_number": "828-575-2625",
            "fax_number": "828-350-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1372 WESTGATE CENTER DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032932",
            "telephone_number": "336-659-4814",
            "fax_number": "336-768-4745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANNELL",
        "first_name": "ELIZABETH",
        "middle_name": "ROSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NC",
            "license": "200200597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952369571",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952369571",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2033561A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.