SALEM PEDIATRIC EAR AND AIRWAY CENTER, PLLC (NPI# 1588025381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588025381 |
| Entity Type | Organization |
| Organization Name | SALEM PEDIATRIC EAR AND AIRWAY CENTER, PLLC |
| Practice Address |
615 Saint George Square Ct Suite 364 Winston Salem NC 27103-1356 |
| Practice Telephone | 3362454972 |
| Practice Fax Number | 3364501676 |
| Mailing Telephone | 3362454972 |
| Mailing Fax Number | 3364501676 |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2016-03-08 |
| Authorized Official Name | ADELE KAREN EVANS (MEMBER MANAGER) |
| Authorized Official Telephone | 9196992269 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YP0228X |
Otolaryngology Specialization: Pediatric Otolaryngology |
2006-00303 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1760414866 | 05 |
| Street Address |
615 SAINT GEORGE SQUARE CT SUITE 364 |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-1356 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154706448 | Latonya Yvette Anderson | In Home Supportive Care | 615 Saint George Square Ct, Suite 300, Winston Salem, NC 27103-1356 | 2015-07-28 |
| 1851915045 | Thomasene Wilson | Home Health Aide | 615 Saint George Square Ct, Winston Salem, NC 27103-1356 | 2020-06-03 |
| 1669996229 | Fortitude Counseling Services | Counselor | 615 Saint George Square Ct, Winston Salem, NC 27103-1356 | 2017-07-26 |
| 1811357429 | Shawanna Nicole Moore | Counselor | 615 Saint George Square Ct, Winston Salem, NC 27103-1356 | 2016-02-25 |
| 1740666171 | Legacy Home Care | In Home Supportive Care | 615 Saint George Square Ct, Winston Salem, NC 27103-1356 | 2015-08-07 |
| 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 | 207YP0228X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Pediatric Otolaryngology |
| A pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear and other areas of the head and neck. The pediatric otolaryngologist has special skills in the diagnosis, treatment, and management of childhood disorders of voice, speech, language and hearing. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215911698 | Daniel Jeffrey Kirse | Otolaryngology | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2005-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558628537 | Reema Kirit Padia | Otolaryngology | 103 Lacoste Ln, Cary, NC 27511-6656 | 2012-04-16 |
| 1902177702 | Moses Cone Affiliated Physicians, Inc. | Otolaryngology | 100 E Northwood St, Greensboro, NC 27401-1310 | 2012-01-25 |
| 1386873677 | Wade Glazner Mcclain | Otolaryngology | 170 Manning Dr, #7070, Chapel Hill, NC 27599-7070 | 2009-07-07 |
| 1952309809 | David S Parsons | Otolaryngology | 6035 Fairview Rd, Charlotte, NC 28210-3256 | 2005-07-13 |
| City | WINSTON SALEM |
| Zip Code | 27103 |
Please comment or provide details below to improve the information on SALEM PEDIATRIC EAR AND AIRWAY 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.