Individual provider Active NPI

Jeffery Dale St. Jeor, MD

  • Orthopaedic Surgery Physician
  • Winston Salem, NC
National Provider Identifier
1962081489
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
RTL21-0542 Issued in NC
Practice address
Wake Forest Baptist Medical Center Medical Center Boule
Winston Salem, NC 27157-0001
Phone
(336) 716-3932
Fax
(336) 716-3861
NPI assigned
Apr 2, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X RTL21-0542 NC Primary

Addresses

Primary practice location

Wake Forest Baptist Medical Center Medical Center Boule
Winston Salem, NC 27157-0001

Mailing address

6215 Hamptonburg Rd
Clemmons, NC 27012-8293
Phone (801) 400-7288

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
I20210607003218 NC Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic Surgery 5193125557

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RTL21-0542NCMDOrthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1962081489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6215 HAMPTONBURG RD",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128293",
            "telephone_number": "801-400-7288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WAKE FOREST BAPTIST MEDICAL CENTER MEDICAL CENTER BOULE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-3932",
            "fax_number": "336-716-3861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. JEOR",
        "first_name": "JEFFERY",
        "middle_name": "DALE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-02",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "RTL21-0542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.