PLASTIC SURGERY CENTER OF NC INC (NPI# 1013002138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013002138 |
| Entity Type | Organization |
| Organization Name | PLASTIC SURGERY CENTER OF NC INC |
| Practice Address |
2901 Maplewood Ave Winston Salem NC 27103-4009 |
| Practice Telephone | 3367658620 |
| Practice Fax Number | 3367686236 |
| Mailing Telephone | 3367658620 |
| Mailing Fax Number | 3367686236 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2007-08-01 |
| Authorized Official Name | DR. JOHN ANDERSON FAGG (PRESIDENT) |
| Authorized Official Telephone | 3367658620 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | PLASTIC SURGERY CENTER OF NC INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
200001355455 | NC | Allopathic & Osteopathic Physicians |
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
200001349669 | NC | Allopathic & Osteopathic Physicians |
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
200001376220 | NC | Allopathic & Osteopathic Physicians |
| Street Address |
2901 MAPLEWOOD AVE |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-4009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760777932 | Leslie Grace Branch | Surgery | 2901 Maplewood Ave, Winston Salem, NC 27103-4009 | 2011-06-15 |
| 1225185010 | George Asbury Lawson IIi | Plastic Surgery | 2901 Maplewood Ave, Winston Salem, NC 27103-4009 | 2007-01-04 |
| 1811090475 | Forsyth Plastic Surgical Assoc Pa | Plastic Surgery | 2901 Maplewood Ave, Winston Salem, NC 27103 | 2006-09-07 |
| 1578504726 | Gilson John Kingman | Otolaryngology | 2901 Maplewood Ave, Winston Salem, NC 27103 | 2006-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841785243 | Rachel A Cooley | Surgery | 1 Medical Center Blvd, Winston Salem, NC 27157-0001 | 2018-06-27 |
| 1760777932 | Leslie Grace Branch | Surgery | 2901 Maplewood Ave, Winston Salem, NC 27103-4009 | 2011-06-15 |
| 1184646580 | John Herman Wright Jr. | Surgery | 145 Kimel Park Dr, Suite 280, Winston Salem, NC 27103-6972 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447813753 | Kds Aesthetics, Pllc | Surgery | 2806b Wooten Blvd., Wilson, NC 27893-8624 | 2019-04-22 |
| 1124681689 | Cami Surgery Center, Pllc | Surgery | 8712 Lindholm Dr Ste 308, Huntersville, NC 28078-1872 | 2019-04-19 |
| 1154777936 | Shuting Zhong | Surgery | 130 Manson Farm Rd # 2100, Chapel Hill, NC 27599-0001 | 2016-05-10 |
| 1205216173 | Henry Neale Sr. | Surgery | 117 Shenandoah Terrace, Montreat, NC 28757 | 2015-06-04 |
| 1689940603 | Asheville Aesthetic Plastic Surgery | Surgery | 108 Yorkshire Street, Suite D, Asheville, NC 28803-2759 | 2012-03-23 |
| 1245428358 | Jeyhan S Wood | Surgery | 7033 Burnett Womack Bldg Cb 7195, Chapel Hill, NC 27599-0001 | 2007-10-15 |
| 1255528477 | Rutherford Hospital, Inc. | Surgery | 128 Doctor Henry Norris Dr, Rutherfordton, NC 28139-3165 | 2007-10-02 |
| 1215144670 | David Hardman Harley | Surgery | 13620 Reese Blvd E, Suite 110, Bldg Xii, Huntersville, NC 28078-6417 | 2007-05-16 |
| 1043356868 | Tor Martin Ljung | Surgery | 6752 Parker Farm Dr # 200, Wilmington, NC 28405-3175 | 2007-01-29 |
| 1669538971 | Southland Plastic Surgery | Surgery | 501 North Aspen St, Lincolnton, NC 28092-2105 | 2006-12-29 |
| Find all providers with the same taxonomy | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.