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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | 7000169 | 05 |
Other Name | Type Code |
---|---|
Wellness Ctr. Student Blue | Other Name - Individual/Organization |
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 |
Street Address |
601 S MARTIN LUTHER KING JR DR A.H. RAY BLDG RM. 244 |
City | WINSTON SALEM |
State | NC |
Zip Code | 27110-0001 |
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 |
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 Code | 261QS1000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Student Health |
Definition to come... |
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 |
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 |
Find all providers with the same taxonomy |
City | WINSTON SALEM |
Zip Code | 27110 |
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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.