Individual provider Active NPI

David M. Colonna, M.D.

  • Anesthesiology Physician
  • Winston Salem, NC
National Provider Identifier
1962425694
Registry record updated Mar 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
34961 Issued in NC
Practice address
145 Kimel Park Dr Ste 120
Winston Salem, NC 27103-6983
Phone
(336) 768-3212
Fax
(336) 768-9019
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 34961 NC Primary

Addresses

Primary practice location

145 Kimel Park Dr Ste 120
Winston Salem, NC 27103-6983

Mailing address

145 Kimel Park Dr Ste 120
Winston Salem, NC 27103-6983
Phone (336) 768-3212

Other identifiers 3

IdentifierTypeStateIssuer
13734OtherNCBCBS
P00231618OtherRR MEDICARE
8923807MedicaidNC

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
I20040823001119 NC Practitioner - Anesthesiology 1153393764

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Community Physicians PC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1962425694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 KIMEL PARK DR STE 120",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036983",
            "telephone_number": "336-768-3212",
            "fax_number": "336-768-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 KIMEL PARK DR STE 120",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036983",
            "telephone_number": "336-768-3212",
            "fax_number": "336-768-9019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLONNA",
        "first_name": "DAVID",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "34961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "13734",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00231618",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8923807",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.