KEYSTONE WSNC, LLC (NPI# 1922038082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922038082 |
| Entity Type | Organization |
| Organization Name | KEYSTONE WSNC, LLC |
| Other Organization Name | OLD VINEYARD BEHAVIORAL HEALTH SERVICES |
| Practice Address |
3637 Old Vineyard Rd Winston Salem NC 27104-4842 |
| Practice Telephone | 3367943550 |
| Practice Fax Number | 3367943545 |
| Mailing Telephone | 3367943550 |
| Mailing Fax Number | 3367943545 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2014-12-19 |
| Authorized Official Name | STEVE FILTON (SR VP CFO) |
| Authorized Official Telephone | 6107683300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 323P00000X | Psychiatric Residential Treatment Facility | MHH0188 | NC | Residential Treatment Facilities |
| Y | 283Q00000X | Psychiatric Hospital | MHH0188 | NC | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3404007 | 05 | |
| NC | 3404520 | 05 |
| Other Name | Type Code |
|---|---|
| Old Vineyard Behavioral Health Services | Doing Business As Name - Organization |
| Street Address |
3637 OLD VINEYARD RD |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27104-4842 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043869746 | Lisa Maria Waye | Nurse Practitioner | 3637 Old Vineyard Rd, Winston Salem, NC 27104-4842 | 2019-09-05 |
| 1942606629 | Theresa Economos | Social Worker | 3637 Old Vineyard Rd, Winston Salem, NC 27104-4842 | 2014-11-07 |
| 1780817452 | Keystone Wsnc LLC | Psychiatry & Neurology | 3637 Old Vineyard Rd, Winston Salem, NC 27104 | 2009-08-28 |
| 1922217306 | Gisela Edith Knebl Kohl | Psychiatry & Neurology | 3637 Old Vineyard Rd, Winston Salem, NC 27104-4842 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447807664 | Cameron Grant Ford | Psychologist | 614 Country Club Road, Winston-salem, NC 27104 | 2019-08-22 |
| 1104310374 | Novant Medical Group, Inc. | Internal Medicine | 4937 Old Country Club Rd, Winston Salem, NC 27104 | 2018-06-20 |
| 1982100509 | Dillon James Magalski | Student in an Organized Health Care Education/Training Program | Piedmont Plaza 1, 1920 West First Street, Wake Forest Baptist Medical Center, Winston-salem, NC 27104 | 2018-04-03 |
| 1891290144 | Breann M Poling | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Center, Department Of, Family Medicine Piedmont Plaza I 1920 West First Street, Winston Salem, NC 27104 | 2018-03-28 |
| 1689178600 | Christopher Vasil | Student in an Organized Health Care Education/Training Program | Piedmont Plaza I, 1920 West First Street, Department of Family Medicine, Winston Salem, NC 27104 | 2018-03-23 |
| 1407379126 | April Lynn Lowe | Registered Nurse | 940 N Peace Haven Rd, Winstonsalem, NC 27104 | 2017-07-25 |
| 1164950804 | Donald Joyce | Student in an Organized Health Care Education/Training Program | 1920 West First St, Piedmont Plaza I Building, 3rd Floor, Winston-salem, NC 27104 | 2017-05-25 |
| 1255867289 | Benjamin Hansen | Pharmacist | 2150 Country Club Rd Ste 300, Winston Salem, NC 27104 | 2017-05-11 |
| 1770020976 | Jane Reed | Physical Medicine & Rehabilitation | 2627 E Greenbrier Road, Winston Salem, NC 27104 | 2017-01-25 |
| 1053728261 | Ashraf Alsaedi | Pharmacist | 1659 Stratford Rd Nw, Winston Salem, NC 27104 | 2014-07-20 |
| Find all providers in zip 27104 | ||||
| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811406051 | Triangle Springs, LLC | Psychiatric Hospital | 10901 World Trade Blvd., Raleigh, NC 27617-4203 | 2017-09-20 |
| 1730623182 | Ralph Newman | Psychiatric Hospital | 1019 Bookmark Trl, Durham, NC 27703-9871 | 2016-12-05 |
| 1962887281 | North Carolina Agricultural and Technical State University | Psychiatric Hospital | 913 Bluford St., Greensboro, NC 27401 | 2015-07-28 |
| 1881085264 | Fayetteville Va Medical Cener | Psychiatric Hospital | 1111 Shell Dr, Apt 60, Spring Lake, NC 28390-2050 | 2015-02-06 |
| 1992044143 | Holly Hill Hospital Mobile Crisis | Psychiatric Hospital | 943 W Andrews Ave Ste K, Henderson, NC 27536-2587 | 2013-02-07 |
| 1487999652 | Unc-chapel Hill | Psychiatric Hospital | Unc Ch, 101 Manning Dr. Cb7167, Chapel Hill, NC 27599-0001 | 2012-11-29 |
| 1407096100 | Recovery Response Center | Psychiatric Hospital | 300 Parkview Drive, Henderson, NC 27536 | 2009-02-20 |
| 1639357429 | Sbh- Wilmington, LLC | Psychiatric Hospital | 2050 Mercantile Drive, Leland, NC 28451 | 2008-02-05 |
| 1295938652 | Linda Ruth Derbes | Psychiatric Hospital | 4919 S Miami Blvd, Durham, NC 27703-8435 | 2007-06-06 |
| 1992851331 | Julian F Keith Alcohol and Drug Abuse Treatment Center | Psychiatric Hospital | 201 Tabernacle Road, Black Mountain, NC 28711 | 2007-01-26 |
| Find all providers with the same taxonomy | ||||
| City | WINSTON SALEM |
| Zip Code | 27104 |
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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.