Ryan Michael Wolf, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2023-00579 Issued in NC

Practice address

Medical Center Blvd
Winston Salem, NC 27157-9760

Phone

(336) 716-9252

Fax

(336) 713-9387

NPI assigned

Apr 2, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rwolf36400@direct.vumc.org
• Direct secure messaging: rwolf2754314@carolinashealthcaresystem.direct-ci.com

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.

• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  Medicare reassignment NPD

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

{
    "created_epoch": "1491091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1992237515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-716-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271579760",
            "telephone_number": "336-716-9252",
            "fax_number": "336-713-9387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 The Vanderbilt Clinic",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372329760",
            "country_code": "US",
            "telephone_number": "615-322-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Childrens Way",
            "address_2": "8161 DOT, Vanderbilt Pediatric Residency Program",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372329760",
            "country_code": "US",
            "telephone_number": "615-936-2555",
            "fax_number": "615-936-3601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLF",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-02",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "60998",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2023-00579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rwolf36400@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "3601 The Vanderbilt Clinic",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372329760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ivan Wolanin, PHARMD
• Jobira Anbessie Woldemichael, MD
• Cara Elizabeth Harrity Wolf, CNM
• Karen Michelle Wolf
• Patricia Ann Wolf, BT
• Wolfe & Jackson Family Care Home
• Wolfe & Jackson Family Care Home
• Wolfe & Jackson Group Home, Inc
• Wolfe & Jackson Group Home, Inc.
• April B. Wolfe, OTR/L

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; 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.

Verify at the official NPI Registry.