WAKE FOREST UNIVERSITY (NPI# 1265678817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265678817 |
| Entity Type | Organization |
| Organization Name | WAKE FOREST UNIVERSITY |
| Other Organization Name | WAKE FOREST UNIVERSITY SPORTS MEDICINE |
| Practice Address |
Wingate Road, Reynolds Gymnasium Room 106 Winston-salem NC 27106 |
| Practice Telephone | 3367585620 |
| Practice Fax Number | 3367586149 |
| Mailing Telephone | 3367585620 |
| Mailing Fax Number | 3367586149 |
| Enumeration Date | 2009-01-05 |
| Last Update Date | 2015-08-19 |
| Authorized Official Name | GREG COLLINS (ASSISTANT ATHLETIC DIRECTOR) |
| Authorized Official Telephone | 3367585620 |
| Authorized Official Credential | ATC |
| Is Organization Subpart | Y |
| Parent Organization Name | WAKE FOREST UNIVERSITY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Wake Forest University Sports Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285717694 | Wake Forest University | Pharmacy | Lwr Level Reynolds Gym Wingate Rd, Winston-salem, NC 27109 | 2006-10-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | WAKE FOREST UNIVERSITY | 1834 Wake Forest Rd, Winston Salem, NC 27109-6000 |
| Washington State Corporations | WAKE FOREST UNIVERSITY | 1834 Wake Forest Rd, Winston Salem, NC 27109-6000 |
| Oklahoma Business Registrations | WAKE FOREST UNIVERSITY | Po Box 7227, Winston Salem, NC 27109 |
| Oklahoma Business Registrations | WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER | 1920 West First St, Winston Salem, NC 27157 |
| Virginia Business Entities | Wake Forest University Baptist Medical Center | Department of Legal Affairs, Medical Center Blvd, Winston-salem, North Carolina 27157 |
| System for Award Management (SAM) Entities | WAKE FOREST UNIVERSITY HEALTH SCIENCES | Medical Center Blvd, Winston Salem, NC 27157-0001 |
| Oklahoma Business Registrations | WAKE FOREST UNIVERSITY HEALTH SCIENCES | 1920 West First St, Winston Salem, NC 27104 |
| Street Address |
WINGATE ROAD, REYNOLDS GYMNASIUM ROOM 106 |
| City | WINSTON-SALEM |
| State | NC |
| Zip Code | 27106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437799103 | Tyler Laura Lawrence | Behavioral Analyst | 1959 N Peace, 104, Winston-salem, NC 27106 | 2020-01-10 |
| 1316504624 | Amanda Baker | Behavior Technician | 1959 N Peace Haven Rd, Suite 104, Winston Salem, NC 27106 | 2019-05-22 |
| 1679030316 | Lavonda Williams | Behavior Technician | 1959 N Peace Haven Road, Winston Salem, NC 27106 | 2019-03-01 |
| 1518436708 | Angela Ruth Brown | Physical Therapy Assistant | 190 Moravian Way Drive, Winston-salem, NC 27106 | 2018-11-16 |
| 1407378896 | Applied Family Services of Winston-salem | Early Intervention Provider Agency | 4220 Witherow Rd, Winston Salem, NC 27106 | 2017-07-07 |
| 1750801676 | Julia Ann Horton | Speech-Language Pathologist | 2000 Salemtowne Drive, Winston Salem, NC 27106 | 2017-06-21 |
| 1124548037 | Tyler John Jones | Community Health Worker | 7014 Brandemere Ln. Apt F, Winston Salem, NC 27106 | 2017-06-21 |
| 1396274759 | Jennifer Cui | Social Worker | 3216 Cross Tree Rd, Winston-salem, NC 27106 | 2017-06-08 |
| 1063947802 | Rebecca Jeanette Mclemore | Social Worker | 4401 Providence Ln. #121, Top Priority Care Services, LLC., Winston-salem, NC 27106 | 2017-05-01 |
| 1720529357 | Rising Hope Clinical Assistance, LLC | Community/Behavioral Health | 510 Northgate Park Dr, Winston Salem, NC 27106 | 2017-03-15 |
| Find all providers in zip 27106 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496757 | North Carolina Physical Therapy | Clinic/Center | 223 E Chatham St Ste 101, Cary, NC 27511-3475 | 2020-10-29 |
| 1750988861 | Homefront Physical Therapy, LLC | Clinic/Center | 100 Fullard Dr, Sneads Ferry, NC 28460-9530 | 2020-10-02 |
| 1861009144 | Radiance Physical Therapy LLC | Clinic/Center | 9 Richmond Ct, Durham, NC 27713-8376 | 2020-09-30 |
| 1386250124 | Nicol Chiropractic Center | Clinic/Center | 7011 Fayetteville Rd Ste 106b, Durham, NC 27713-7745 | 2020-09-17 |
| 1295349231 | All Natural Female LLC | Clinic/Center | 10314 Kirkmont Dr, Charlotte, NC 28269-6219 | 2020-09-08 |
| 1538773064 | Congruency Therapy & Wellness LLC | Clinic/Center | 5045 Strawberry Hill Dr Apt D, Charlotte, NC 28211-4535 | 2020-09-02 |
| 1093329617 | Begin With Breath, LLC | Clinic/Center | 37 Hampden Rd, Asheville, NC 28805-2421 | 2020-09-01 |
| 1225641020 | Flo Physical Therapy & Performance LLC | Clinic/Center | 13959 Tom Short Rd, Marvin, NC 28173-5300 | 2020-08-31 |
| 1689286122 | 2662 Pursuits LLC | Clinic/Center | 279 Paragon Pkwy, Clyde, NC 28721-8509 | 2020-08-17 |
| 1255958930 | Rise Physical Therapy LLC | Clinic/Center | 3710 Exchange Glenwood Pl Apt 346, Raleigh, NC 27612-4853 | 2020-06-29 |
| Find all providers with the same taxonomy | ||||
| City | WINSTON-SALEM |
| Zip Code | 27106 |
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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.