WINSTON-SALEM STATE UNIVERSITY


Address: 601 S Martin Luther King Jr Dr, A.h. Ray Bldg Rm. 244, Winston Salem, NC 27110-0001
Phone: 3367503301

WINSTON-SALEM STATE UNIVERSITY (NPI# 1851713374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1851713374
Entity Type Organization
Organization Name WINSTON-SALEM STATE UNIVERSITY
Other Organization Name WELLNESS CTR. STUDENT BLUE
Practice Address 601 S Martin Luther King Jr Dr
A.h. Ray Bldg Rm. 244
Winston Salem
NC 27110-0001
Practice Telephone 3367503301
Practice Fax Number 3367503303
Mailing Telephone 3367503301
Mailing Fax Number 3367503303
Enumeration Date 2014-01-17
Last Update Date 2014-01-17
Authorized Official Name ANTHONY PHILADELPHIA (DIRECTOR)
Authorized Official Telephone 3367503274
Authorized Official Credential PHD.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207Q00000X Family Medicine Allopathic & Osteopathic Physicians
N 363LF0000X Nurse Practitioner
Specialization: Family
Physician Assistants & Advanced Practice Nursing Providers
Y 261QS1000X Clinic/Center
Specialization: Student Health
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
NC 7000169 05

Other Provider/Organization Names

Other Name Type Code
Wellness Ctr. Student Blue Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1144649948 Winston-salem State University Clinic/Center 1250 S Mlk Jr Dr, Winston Salem, NC 27107-1370 2014-04-09

Office Location

Street Address 601 S MARTIN LUTHER KING JR DR
A.H. RAY BLDG RM. 244
City WINSTON SALEM
State NC
Zip Code 27110-0001

Providers in the same location

NPI Name Taxonomy Address Enumeration
1629005657 Darrell Matthew Turner Specialist/Technologist 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0003 2006-06-26
1265047161 Hannah Martin Occupational Therapist 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0001 2020-09-09
1033723077 Brittany Dixon Occupational Therapist 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0003 2020-09-08
1316552243 Sheniah Campbell Occupational Therapist 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0001 2020-09-08
1942815873 Jaiven Knight Occupational Therapist 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0003 2020-09-08
1235743204 Troy Jones Occupational Therapist 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0003 2020-09-07
1194339192 Jonathan Brown Occupational Therapist 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0003 2020-09-07
1013521079 Jonelle Claricia Bedford Occupational Therapist 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0003 2020-09-06
1033723267 Savannah K Dorman Occupational Therapist 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0003 2020-09-04
1902410079 Greyson Ray Occupational Therapist 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0003 2020-09-04
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1326652454 Erica Shade Occupational Therapist 601 Martin Luther King Jr. Dr, 432 Fl Atkins Building, Winston-salem, NC 27110 2020-09-05
1841804838 Lisa Hartwell Occupational Therapist 601 Martin Luther King Jr. Dr, 432 Fl Atkins Building, Winston-salem, NC 27110 2020-09-07
1801140702 Dina Vallabh Speech-Language Pathologist 155 Baker House Trent Drive, Durham, NC 27110 2012-10-31
1386258432 Valerie Miller Student in an Organized Health Care Education/Training Program 601 Mlk Jr Dr, Winston Salem, NC 27110-0001 2020-09-05
1942814074 Joyous Hawkins Student in an Organized Health Care Education/Training Program 601 S Martin Luther King, Winston Salem, NC 27110-0001 2020-09-05
1306450408 Katlyn Maiolo Occupational Therapist 601 Martin Luther King Jr. Drive, 432 Fl Atkins Building, Winston-salem, NC 27110-0001 2020-09-04
1649884701 Lila Grafius Occupational Therapist 601 Martin Luther King Dr 432 Fl Atkins Building, Winston Salem, NC 27110-0001 2020-09-04
1326652504 Emily Claire Skoglund Student in an Organized Health Care Education/Training Program 601 S Martin Luther King Jr Dr Fl 432, Winston Salem, NC 27110-0001 2020-09-03
1366927659 Judy Larose Foxworth Physical Therapist 601 S Mlk Jr Drive F L Atkins Bldg Rm 333, Winston Salem, NC 27110-0001 2018-10-02
1285138123 Jessica Um Occupational Therapist 601 Martin Luther King Jr Dr, 432 Fl Atkins Building, Winston-salem, NC 27110-0001 2018-03-23
Find all providers in zip 27110

Taxonomy Information

Taxonomy Code 261QS1000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Student Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1144649948 Winston-salem State University Clinic/Center 1250 S Mlk Jr Dr, Winston Salem, NC 27107-1370 2014-04-09
1639633886 Gaston Family Health Services, Inc. Clinic/Center 2355 Pleasant St, Winston Salem, NC 27107-4334 2019-01-22
1801377106 Gaston Family Health Services, Inc. Clinic/Center 5705 Shattalon Dr, Winston Salem, NC 27105-1332 2018-08-24
1831439637 School Health Alliance for Forsyth County Clinic/Center 4555 Ogburn Ave, Winston Salem, NC 27105-2726 2013-02-15
1376716811 Winston Salem State University, A. H. Ray Student Health Service Clinic/Center 601 S Martin Luther King Jr Dr, Rm 244, A. H. Ray Building, Winston Salem, NC 27110-0001 2008-04-04
1154453496 Gaston Family Health Services, Inc. Clinic/Center 4555 Ogburn Ave, Winston Salem, NC 27105-2726 2007-03-12
1982732269 School Health Alliance for Forsyth County Clinic/Center 4555 Ogburn Ave, Winston Salem, NC 27105-2726 2007-03-01
1093868242 Nc School of Arts Clinic/Center 1533 S Main St, Winston Salem, NC 27127-2738 2007-01-19

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1306450887 Brocker Health Center/ Unc Charlotte Clinic/Center 9201 University City Blvd Student Health Center, Charlotte, NC 28223-0001 2020-09-02
1700439023 Fayetteville State University Clinic/Center 1200 Murchison Road, Fayetteville State University The, Fayetteville, NC 28301-4252 2019-07-17
1497132963 Wingate University Clinic/Center 109 N. Camden Rd, Wingate, NC 28174 2015-05-04
1538394358 The University of North Carolina At Asheville Clinic/Center One University Heights, Weizenblatt Building, Asheville, NC 28804-8514 2009-05-22
1407038615 The James A Taylor Student Health Services Sports Medicine Department Clinic/Center The James A Taylor Student Health Services Cb# 7470, The University of North Carolina At Chapel Hill, Chapel Hill, NC 27599-7470 2007-11-29
1083807325 Adolescent Care Center Clinic/Center 88 Us Highway 158 W, Gatesville, NC 27938-9438 2007-08-21
1578764312 Hope Physicians Clinic/Center 2502 N Herritage Street, Suite A, Kinston, NC 28501-3567 2007-05-30
1033321005 Anna Gove Student Health Services Clinic/Center 107 Gray Dr., Greensboro, NC 27402 2007-05-04
1073733390 Davidson College Student Health Service Clinic/Center 514 N. Main St, Davidson, NC 28036 2007-04-27
1053452953 Wake Forest University Student Health Service Clinic/Center 1834 Reynolda Road, Mackie Health Center - Reynolds Gym - Wingate Rd. Wfu, Winston-salem, NC 27106 2007-02-12
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Competitor

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City WINSTON SALEM
Zip Code 27110

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Dataset Information

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.

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