DR. NICHOLAS JOSEPH COSTA II (NPI# 1629368931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629368931 |
| Entity Type | Individual |
| Full Name | DR. NICHOLAS JOSEPH COSTA II |
| Credential | MD |
| Practice Address |
186 Kimel Park Dr Winston Salem NC 27103 |
| Mailing Address |
Po Box 751803 Charlotte NC 28275-1803 |
| Practice Telephone | 3362772000 |
| Practice Fax Number | 3362772050 |
| Mailing Telephone | 3362772000 |
| Mailing Fax Number | 3362772050 |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2020-10-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 2019-00725 | NC | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | D0079810 | MD | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
2019-00725 | NC | Allopathic & Osteopathic Physicians |
| Y | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
2019-00725 | NC | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 419 W Redwood St, Baltimore, MD 212011734 | 4103287877 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639737877 | Nicholas Bradely Costa | Specialist/Technologist | 2240 Raymond Ave, Missoula, MT 59802-3512 | 2019-06-03 |
| 1124555107 | Nicholas Costa | Specialist | 5 Beaver Pond Ct, Stony Point, NY 10980-3518 | 2017-05-22 |
| Street Address |
186 KIMEL PARK DR |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871587923 | Kenneth E Bodek | Internal Medicine | 186 Kimel Park Dr, Suite 400, Winston Salem, NC 27103-6946 | 2005-09-06 |
| 1851940753 | Casey Leigh Hardy | Nurse Practitioner | 186 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2019-09-04 |
| 1881248029 | Ennie Austin | Nurse Practitioner | 186 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2019-07-26 |
| 1972023737 | Francis Wingate Hayes Iv | Nurse Practitioner | 186 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2017-06-22 |
| 1255786273 | Nathan Mcgeathy | Nurse Practitioner | 186 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2016-04-27 |
| 1376925214 | Joseph Mintz | Physician Assistant | 186 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2015-06-27 |
| 1679961353 | Michelle Swaim | Nurse Practitioner | 186 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2015-01-02 |
| 1508107707 | Jennifer Doby Davis | Nurse Practitioner | 186 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2013-03-13 |
| 1255682415 | Dawn Marie Delo O'reilly | Physician Assistant | 186 Kimel Park Dr, Winston Salem, NC 27103 | 2012-09-27 |
| 1639431307 | Bradley Walton Clark | Internal Medicine | 186 Kimel Park Dr, Winston Salem, NC 27103 | 2012-06-08 |
| Find all providers in the same location | ||||
| 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 | 207RC0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Clinical Cardiac Electrophysiology |
| A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801495387 | Gillian Grace Winter | Internal Medicine | 1 Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-10-26 |
| 1326306168 | Matthew Justin Singleton | Internal Medicine | 1 Medical Center Blvd, Winston Salem, NC 27157-0001 | 2012-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316120017 | Anil K Gehi | Internal Medicine | 6025 Burnett Womack Bldg Cb 7075, 160 Dental Circle, Chapel Hill, NC 27599-7075 | 2007-12-17 |
| 1114076395 | David W Frazier | Internal Medicine | 2340 Hemby Lane, Suite 100, Greenville, NC 27834 | 2007-01-09 |
| 1275557571 | Sherry Saxonhouse | Internal Medicine | 307 Yadkin St, Albemarle, NC 28001-3441 | 2006-07-27 |
| 1720042013 | Angela M Park | Internal Medicine | 1001 Newman Rd, New Bern, NC 28562-5253 | 2006-04-13 |
| 1588624217 | Hemantkumar Patel | Internal Medicine | 800 Jefferson St, Ste 112, Whiteville, NC 28472-3710 | 2006-03-25 |
| 1922009935 | Sanjay Prasher | Internal Medicine | 2301 Robeson St, Suite 301, Fayetteville, NC 28305-5640 | 2005-08-02 |
| 1154320307 | John Mark Englehardt | Internal Medicine | 3324 Six Forks Rd, Raleigh, NC 27609-7233 | 2005-07-19 |
| 1063077436 | Wakemed Specialists Group, LLC | Internal Medicine | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2019-05-01 |
| 1780076000 | Wake Specialty Physicians LLC | Internal Medicine | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2015-02-24 |
| 1851782593 | Wake Specialty Physicians LLC | Internal Medicine | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2015-02-17 |
| 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.