Stephen Brooks Irvin, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-02196 Issued in NC

Practice address

1834 Wake Forest Rd
Winston Salem, NC 27109-6000

Phone

(336) 758-5218

NPI assigned

Feb 8, 2010

Last updated

Apr 28, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Philip D. Burton M.D. PLLC

  • Family Medicine Physician
  • Wake Forest, NC
  • NPI 1922290881
  NPD (past)
• Wake Forest University

  dba Wake Forest University Student Health

  • Institutional Pharmacy
  • Winston Salem, NC
  • NPI 1285717694
  NPD (past)
• Wake Forest University Student Health Service

  • Student Health Clinic/Center
  • Winston Salem, NC
  • NPI 1053452953
  NPD (past)

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

{
    "created_epoch": "1265587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493337600000",
    "number": "1962734442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7386",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271096233",
            "telephone_number": "336-758-5218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1834 WAKE FOREST RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271096000",
            "telephone_number": "336-758-5218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRVIN",
        "first_name": "STEPHEN",
        "middle_name": "BROOKS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-08",
        "last_updated": "2017-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-02196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Ioan, RD, LDN
• Wesley Hayden Iobst
• Iparc Alternative Living LLC
• Karina Farhad Irani, MD
• Maria Eugenia Iruela, M.D.
• Irving's ABA Therapy
• Andrew Paul Irwin-Smiler, PHD, MA
• Jordan Tyler Irwin
• Tammy Irwin, MS, CCC-SLP
• Jennifer Burwell Isaac, PA-C

• Medical Physician Assistant in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.