WINTERGREEN MEDICAL CENTER, PLLC (NPI# 1225238009) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225238009 |
| Entity Type | Organization |
| Organization Name | WINTERGREEN MEDICAL CENTER, PLLC |
| Practice Address |
324a Beacon Dr Winterville NC 28590-7956 |
| Mailing Address |
324-a Beacon Dr Winterville NC 28590-7956 |
| Practice Telephone | 2525515595 |
| Practice Fax Number | 2523217762 |
| Mailing Telephone | 2525515595 |
| Mailing Fax Number | 2523217762 |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2016-02-18 |
| Authorized Official Name | LELAND CALVIN ELLIS (OWNER) |
| Authorized Official Telephone | 2525515595 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | Y |
| Parent Organization Name | WINTERGREEN MEDICAL CENTER, PLLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 141455 | NC | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8976432 | 05 |
| Street Address |
324A BEACON DR |
| City | WINTERVILLE |
| State | NC |
| Zip Code | 28590-7956 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386749695 | Leland Calvin Ellis Jr. | Physician Assistant | 324a Beacon Dr, Winterville, NC 28590-7956 | 2006-09-13 |
| 1215419825 | Carol Josephine Gates | Internal Medicine | 324a Beacon Dr, Winterville, NC 28590-7956 | 2018-08-30 |
| 1063878064 | Robert Barwick | Physician Assistant | 324a Beacon Dr, Winterville, NC 28590-7956 | 2016-01-06 |
| 1811254436 | Leslie C Sexton | Physician Assistant | 324a Beacon Dr, Winterville, NC 28590-7956 | 2012-04-20 |
| 1841366291 | Marshall Craig Simpson | Family Medicine | 324a Beacon Dr, Winterville, NC 28590-7956 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427666130 | Domika Dunn | Non-emergency Medical Transport (VAN) | 2634 Mill Street, #3, Winterville, NC 28590 | 2020-07-20 |
| 1417490194 | Sarah Blakely | Counselor | 367 Branchwood Drive, Winterville, NC 28590 | 2016-11-29 |
| 1740671817 | Faith Lewis Hardison | Social Worker | 173 A Emily Dr., Winterville, NC 28590 | 2015-02-11 |
| 1255740932 | Kendal Williams Strickland | Pharmacist | 4240 Nc Hwy 11 South, Winterville, NC 28590 | 2014-08-07 |
| 1396152757 | Patricia Ragin | Counselor | 1200 Freeland Lane, Unit K1, Winterville, NC 28590 | 2014-07-17 |
| 1780941104 | Triniti House of Restoration | Psychiatric Residential Treatment Facility | 485 Marlboro Drive, Winterville, NC 28590 | 2012-04-23 |
| 1295003002 | Linda Peer Fleming | Psychologist | 108-d West Firetower Rd., Teacch South Hall Professional Center, Winterville, NC 28590 | 2011-12-07 |
| 1740595859 | Christina Neverte Sidrak | Pharmacist | 4211 Nc Highway 11 South, Winterville, NC 28590 | 2010-08-12 |
| 1902124993 | Dove United Counseling and Assessment Services | Counselor | 575 S. Square Drive, Apt 98, Winterville, NC 28590 | 2010-05-14 |
| 1841526407 | Kyle Dombach | Pharmacist | 4211 Winterville Parkway, Winterville, NC 28590 | 2009-11-02 |
| Find all providers in zip 28590 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245334747 | Hicks Chiropractic, P.a. | Clinic/Center | 610 Old Tar Village Rd Ste E, Winterville, NC 28590-7936 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649871807 | Little Beam Rehabilitation Services | Clinic/Center | 1745 Us Highway 64 W, Plymouth, NC 27962-9325 | 2020-11-04 |
| 1962000828 | Flash Rsn Family and Urgent Care, Pllc | Clinic/Center | 316 Summerwalk Rd, Greensboro, NC 27455-1556 | 2020-10-13 |
| 1225645542 | Island Time Medical and Wellness, Pllc | Clinic/Center | 39 Dowitcher Trl, Bald Head Island, NC 28461 | 2020-09-30 |
| 1558977074 | Zoe Wellness | Clinic/Center | 5322 Nc 55, 102, Durham, NC 27713 | 2020-09-21 |
| 1568088672 | Whole Life Chiropractic PC | Clinic/Center | 5410 Page Rd Ste 3, Durham, NC 27703-8230 | 2020-06-24 |
| 1487270674 | Fall Forward Wellness Center | Clinic/Center | 12709 Caldwell Rd, Charlotte, NC 28213-3811 | 2020-06-23 |
| 1710510482 | Tailored Telehealth | Clinic/Center | 218 Westover Dr, Asheville, NC 28801-1638 | 2020-02-20 |
| 1114567930 | Metroview Healthcare Solutions Inc | Clinic/Center | 301 E John St Ste 2501, Matthews, NC 28105-4837 | 2020-01-09 |
| 1174160923 | Newell Health | Clinic/Center | 10208 Cerny St Ste 308, Raleigh, NC 27617-7885 | 2019-11-27 |
| 1871138644 | Ourhealth Physicians Group, LLC | Clinic/Center | 2335 Matthews Township Pkwy Ste 101, Matthews, NC 28105-2403 | 2019-11-15 |
| Find all providers with the same taxonomy | ||||
| City | WINTERVILLE |
| Zip Code | 28590 |
Please comment or provide details below to improve the information on WINTERGREEN MEDICAL CENTER, PLLC.
| 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.