WINSTON-SALEM STATE UNIVERSITY (NPI# 1144649948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144649948 |
| Entity Type | Organization |
| Organization Name | WINSTON-SALEM STATE UNIVERSITY |
| Other Organization Name | WSSU SPORTS MEDICINE |
| Practice Address |
1250 S Mlk Jr Dr Winston Salem NC 27107-1370 |
| Mailing Address |
5050 Spring Valley Rd Dallas TX 75244-3995 |
| Practice Telephone | 3367502597 |
| Mailing Telephone | 8005559073 |
| Mailing Fax Number | 9723673452 |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2014-04-09 |
| Authorized Official Name | MR. IAN MUSHINSKI (HEAD ATHLETIC TRAINER) |
| Authorized Official Telephone | 3367502597 |
| Authorized Official Credential | ATC, LAT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS1000X |
Clinic/Center Specialization: Student Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| WSSU Sports Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851713374 | Winston-salem State University | Family Medicine | 601 S Martin Luther King Jr Dr, A.h. Ray Bldg Rm. 244, Winston Salem, NC 27110-0001 | 2014-01-17 |
| Street Address |
1250 S MLK JR DR |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27107-1370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154934727 | Sreto Duric | Physical Therapy Assistant | 3863 Robbins Brook Dr, Winston Salem, NC 27107 | 2020-08-24 |
| 1164936852 | Lindsay Webster | Physician Assistant | 10479 Nc-109, 107a, Winston Salem, NC 27107 | 2017-11-17 |
| 1447592209 | Vinson Psychological Services, Pllc | Psychologist | 4236 Sherlie Weavil Rd, Winston Salem, NC 27107 | 2013-03-20 |
| 1629212501 | Benicia Elaine Cleveland | Specialist/Technologist | 1250 S Martin Luther King Jr. Drive, Winston-salem State University, Winston-salem, NC 27107 | 2009-04-23 |
| 1083714364 | Lia Simpson Erickson | Pediatrics | 648 East Monmouth Street, Winston Salem, NC 27107 | 2006-09-25 |
| 1336242973 | North Carolina Cvs Pharmacy LLC | Pharmacy | 10478 N Nc Hwy 109, Wallburg, NC 27107 | 2006-09-07 |
| 1154816312 | Janel Rebecca Durham | Nurse Practitioner | 10479 N Nc Highway 109 Ste 107a, Winston Salem, NC 27107 | 2018-06-28 |
| 1861929523 | Southside United Health Centers | Social Worker | 3009 Waughtown St, Winston Salem, NC 27107 | 2017-05-12 |
| 1407011398 | Ashley Rose Hill | Nurse Practitioner | 648 East Monmouth Street, Winston Salem, NC 27107 | 2008-07-21 |
| 1518157247 | Ellen R. Robinson | Pediatrics | 648 East Monmouth Street, Winston Salem, NC 27107 | 2007-07-30 |
| Find all providers in zip 27107 | ||||
| Taxonomy Code | 261QS1000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Student Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639633886 | Gaston Family Health Services, Inc. | Clinic/Center | 2355 Pleasant St, Winston Salem, NC 27107-4334 | 2019-01-22 |
| 1801377106 | Gaston Family Health Services, Inc. | Clinic/Center | 5705 Shattalon Dr, Winston Salem, NC 27105-1332 | 2018-08-24 |
| 1831439637 | School Health Alliance for Forsyth County | Clinic/Center | 4555 Ogburn Ave, Winston Salem, NC 27105-2726 | 2013-02-15 |
| 1376716811 | Winston Salem State University, A. H. Ray Student Health Service | Clinic/Center | 601 S Martin Luther King Jr Dr, Rm 244, A. H. Ray Building, Winston Salem, NC 27110-0001 | 2008-04-04 |
| 1154453496 | Gaston Family Health Services, Inc. | Clinic/Center | 4555 Ogburn Ave, Winston Salem, NC 27105-2726 | 2007-03-12 |
| 1982732269 | School Health Alliance for Forsyth County | Clinic/Center | 4555 Ogburn Ave, Winston Salem, NC 27105-2726 | 2007-03-01 |
| 1093868242 | Nc School of Arts | Clinic/Center | 1533 S Main St, Winston Salem, NC 27127-2738 | 2007-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306450887 | Brocker Health Center/ Unc Charlotte | Clinic/Center | 9201 University City Blvd Student Health Center, Charlotte, NC 28223-0001 | 2020-09-02 |
| 1700439023 | Fayetteville State University | Clinic/Center | 1200 Murchison Road, Fayetteville State University The, Fayetteville, NC 28301-4252 | 2019-07-17 |
| 1497132963 | Wingate University | Clinic/Center | 109 N. Camden Rd, Wingate, NC 28174 | 2015-05-04 |
| 1538394358 | The University of North Carolina At Asheville | Clinic/Center | One University Heights, Weizenblatt Building, Asheville, NC 28804-8514 | 2009-05-22 |
| 1407038615 | The James A Taylor Student Health Services Sports Medicine Department | Clinic/Center | The James A Taylor Student Health Services Cb# 7470, The University of North Carolina At Chapel Hill, Chapel Hill, NC 27599-7470 | 2007-11-29 |
| 1083807325 | Adolescent Care Center | Clinic/Center | 88 Us Highway 158 W, Gatesville, NC 27938-9438 | 2007-08-21 |
| 1578764312 | Hope Physicians | Clinic/Center | 2502 N Herritage Street, Suite A, Kinston, NC 28501-3567 | 2007-05-30 |
| 1033321005 | Anna Gove Student Health Services | Clinic/Center | 107 Gray Dr., Greensboro, NC 27402 | 2007-05-04 |
| 1073733390 | Davidson College Student Health Service | Clinic/Center | 514 N. Main St, Davidson, NC 28036 | 2007-04-27 |
| 1053452953 | Wake Forest University Student Health Service | Clinic/Center | 1834 Reynolda Road, Mackie Health Center - Reynolds Gym - Wingate Rd. Wfu, Winston-salem, NC 27106 | 2007-02-12 |
| Find all providers with the same taxonomy | ||||
| City | WINSTON SALEM |
| Zip Code | 27107 |
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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.