Active NPI
Jeffery Dale St. Jeor, MD
- Orthopaedic Surgery Physician
- Winston Salem, NC
National Provider Identifier
1962081489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- RTL21-0542
- 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
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 |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210607003218 | NC | Order and Referring Only - Orthopedic Surgery | 5193125557 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RTL21-0542 | NC | MD | Orthopaedic 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; 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.