MDCO PA (NPI# 1649239641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649239641 |
| Entity Type | Organization |
| Organization Name | MDCO PA |
| Other Organization Name | NORTH POINT MEDICAL ASSOCIATES; WEST FORSYTH FAMILY MEDICINE |
| Practice Address |
1995 Bethabara Rd Winston Salem NC 27106-3375 |
| Practice Telephone | 3362450333 |
| Practice Fax Number | 3362450332 |
| Mailing Telephone | 3367597596 |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. TIMOTHY JOHN DALTON (PHYSICIAN) |
| Authorized Official Telephone | 3367597596 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207R00000X | Internal Medicine | 95-00876 | NC | Allopathic & Osteopathic Physicians |
| X | 207R00000X | Internal Medicine | 95-00759 | NC | Allopathic & Osteopathic Physicians |
| X | 208000000X | Pediatrics | 95-00876 | NC | Allopathic & Osteopathic Physicians |
| X | 208000000X | Pediatrics | 95-00759 | NC | Allopathic & Osteopathic Physicians |
| X | 207Q00000X | Family Medicine | 9500876 | NC | Allopathic & Osteopathic Physicians |
| X | 207Q00000X | Family Medicine | 24445 | NC | Allopathic & Osteopathic Physicians |
| X | 207Q00000X | Family Medicine | 9500759 | NC | Allopathic & Osteopathic Physicians |
| X | 363AM0700X |
Physician Assistant Specialization: Medical |
102304 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| X | 363AM0700X |
Physician Assistant Specialization: Medical |
101788 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| X | 363AM0700X |
Physician Assistant Specialization: Medical |
101138 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LAB NP & WF | 330206 | 01 | |
| MAMSI LENDLE | 287314 | 01 | |
| NC | NORTH POINT MEDICAL BCBS | 0222V | 01 |
| UNITED HEALTHCARE WARNMNT | 402116 | 01 | |
| NC | WEST FORSYTH FAMILY BCBS | 0296W | 01 |
| UNITED HEALTHCARE DALTON | 402121 | 01 | |
| PARTNERS NORTH POINT | 3981 | 01 | |
| NC | 890222V | 05 | |
| PARTNERS WEST FORSYTH | 3977 | 01 | |
| NC | 890296W | 05 | |
| UNITED HEALTHCARE LENDLE | 102267 | 01 | |
| RAILROAD WF MEDICARE | CJ5710 | 01 | |
| NP RAILROAD MCR | CN3058 | 01 |
| Other Name | Type Code |
|---|---|
| North Point Medical Associates; West Forsyth Family Medicine | Doing Business As Name - Organization |
| Street Address |
1995 BETHABARA RD |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27106-3375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285129759 | Richard Kohlstadt Godine | Physician Assistant | 1995 Bethabara Rd, Winston Salem, NC 27106-3375 | 2018-06-27 |
| 1508308610 | Nanette Fulp | Physician Assistant | 1995 Bethabara Rd, Winston Salem, NC 27106-3375 | 2016-11-07 |
| 1417336876 | Elizabeth Joan Soto | Physician Assistant | 1995 Bethabara Rd, Winston Salem, NC 27106-3375 | 2015-05-19 |
| 1316295173 | Joanna Elizabeth Long | Nurse Practitioner | 1995 Bethabara Rd, Winston Salem, NC 27106-3375 | 2012-08-27 |
| 1154454825 | Forsyth Memorial Hospital Inc | Internal Medicine | 1995 Bethabara Rd, Winston Salem, NC 27106-3375 | 2007-03-13 |
| 1063433803 | Ana A Frunza | Family Medicine | 1995 Bethabara Rd, Winston Salem, NC 27106-3375 | 2006-07-21 |
| 1649290669 | Robert M. Gay Jr. | Internal Medicine | 1995 Bethabara Rd, Winston Salem, NC 27106-3375 | 2006-07-20 |
| 1225017544 | Harry Turner Hulbert IIi | Physician Assistant | 1995 Bethabara Rd, Winston Salem, NC 27106-3375 | 2006-01-13 |
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1043876055 | Iora Health North Carolina, P.C. | Internal Medicine | 3274 Silas Creek Pkwy, Winston Salem, NC 27103-3010 | 2019-05-15 |
| 1104310374 | Novant Medical Group, Inc. | Internal Medicine | 4937 Old Country Club Rd, Winston Salem, NC 27104 | 2018-06-20 |
| 1740636125 | Joshua W Harbaugh | Internal Medicine | Gme Office Wfbmc Medical Center Blvd, Winston Salem, NC 27157-0001 | 2016-05-04 |
| 1922495795 | Lauren Marie Hartman | Internal Medicine | Sticht Center, 1 Medical Center Blvd, Winston Salem, NC 27517 | 2015-04-20 |
| 1952798985 | Adam Ross Schertz | Internal Medicine | Wake Forest Medical Ctr, Medical Center Blvd, Watlington Hall, 3rd Floor, Winston Salem, NC 27157-0001 | 2015-04-16 |
| 1881002319 | Glorian Mari Roman-ashby | Internal Medicine | Geriatric Clinic-sticht Center Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2014-07-28 |
| 1457648412 | Jiaxi Ding | Internal Medicine | 1340 Creekshire Way Ste 100, Winston Salem, NC 27103-3063 | 2011-06-28 |
| 1730319583 | Jennifer L Gabbard | Internal Medicine | 1 Medical Center Blvd 8th Floor Janeway Tower, Winston Salem, NC 27157-0001 | 2009-07-14 |
| 1730349309 | Willis S Mozingo | Internal Medicine | Wfubmc House Staff Ofc, Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2008-06-16 |
| 1013104520 | Tong Li-masters | Internal Medicine | 830 Rockford Street, Winston Salem, NC 27030 | 2007-09-28 |
| Find all providers in WINSTON SALEM | ||||
| 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.