DR. EDWARD V. SPUDIS (NPI# 1750532180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750532180 |
| Entity Type | Individual |
| Full Name | DR. EDWARD V. SPUDIS |
| Credential | MD |
| Practice Address |
190 Kimel Park Dr Winston Salem NC 27103-6946 |
| Practice Telephone | 3367683296 |
| Practice Fax Number | 3367605854 |
| Enumeration Date | 2008-10-03 |
| Last Update Date | 2008-10-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
0000-11381 | NC | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | STATE MEDICAL LICENSE | 0000-11381 | 01 |
| Street Address |
190 KIMEL PARK DR |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-6946 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073863197 | Department of Veterans Affairs | General Acute Care Hospital | 190 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2012-09-17 |
| 1770847188 | Tracy Maria Powers | Registered Nurse | 190 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2012-06-29 |
| 1891926101 | Leslie Paul Schellbach | Social Worker | 190 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2009-08-04 |
| 1023265956 | Kenneth John Detrick | Psychiatry & Neurology | 190 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2008-08-21 |
| 1093984007 | Jennifer Lynn Herb | Counselor | 190 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2008-02-23 |
| 1790969277 | William R Bodner | Psychiatry & Neurology | 190 Kimel Park Dr, C&p Unit, Winston Salem, NC 27103-6946 | 2007-12-20 |
| 1215111828 | Carey Vastine Stabler | General Practice | 190 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2007-12-19 |
| 1023216199 | Ahunna N Okwubunka-anyim | Family Medicine | 190 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2007-07-10 |
| 1518162460 | Chetan Desai | Internal Medicine | 190 Kimel Park Dr, Va Out-patient Clinic, Winston Salem, NC 27103-6946 | 2007-06-20 |
| 1093770158 | Deborah Lewis Cranfill | Pharmacist | 190 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2006-04-19 |
| 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 | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700131562 | United Health Centers | Clinic/Center | 3009a Waughtown St, Winston Salem, NC 27107-1634 | 2012-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831799667 | Bakersville Community Medical Clinic, Inc | Clinic/Center | 71 Blue Ridge Ln, Burnsville, NC 28714-7270 | 2020-10-30 |
| 1245842178 | Gaston Family Health Services, Inc. | Clinic/Center | 144 William Ellis Dr, Advance, NC 27006-7990 | 2020-08-21 |
| 1851909444 | Gaston Family Health Services, Inc. | Clinic/Center | 302 28th Ave Ne, Hickory, NC 28601-1116 | 2020-07-20 |
| 1750999496 | Gaston Family Health Services, Inc. | Clinic/Center | 180 War Eagle Dr, Mocksville, NC 27028-6151 | 2020-07-20 |
| 1518575265 | Gaston Family Health Services, Inc. | Clinic/Center | 4675 Oxford School Rd, Claremont, NC 28610-9468 | 2020-07-20 |
| 1124636873 | Gaston Family Health Services, Inc. | Clinic/Center | 451 Catawba Valley Blvd, Hickory, NC 28602-9631 | 2020-07-20 |
| 1093323099 | Gaston Family Health Services, Inc. | Clinic/Center | 5040 E Bandys Xrd, Catawba, NC 28609-8075 | 2020-07-16 |
| 1366088957 | Gaston Family Health Services, Inc. | Clinic/Center | 497 Farmington Rd, Mocksville, NC 27028-7639 | 2019-11-19 |
| 1285270868 | Gaston Family Health Services, Inc. | Clinic/Center | 160 Martin Luther King Junior Rd, Mocksville, NC 27028 | 2019-11-19 |
| 1306481957 | Gaston Family Health Services, Inc. | Clinic/Center | 3407 Plateau Rd, Newton, NC 28658-8809 | 2019-11-07 |
| Find all providers with the same taxonomy | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
Please comment or provide details below to improve the information on DR. EDWARD V. SPUDIS.
| 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.