JAY RICHARD SEIDLER (NPI# 1962407254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962407254 |
| Entity Type | Individual |
| Full Name | JAY RICHARD SEIDLER |
| Credential | DO |
| Practice Address |
865 W Lake Dr Mount Airy NC 27030-2157 |
| Mailing Address |
Po Box 751803 Charlotte NC 28275-1803 |
| Practice Telephone | 3367196100 |
| Practice Fax Number | 3367192313 |
| Mailing Telephone | 3367196100 |
| Mailing Fax Number | 3367192313 |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2020-10-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2010-00404 | NC | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 34007261 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1962407254 | 05 | |
| OH | 2252968 | 05 | |
| WV | 2001246000 | 05 | |
| NC | 5914840 | 05 |
| Street Address |
865 W LAKE DR |
| City | MOUNT AIRY |
| State | NC |
| Zip Code | 27030-2157 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942795323 | Kristy Lynette Mabe | Social Worker | 865 W Lake Dr, Mount Airy, NC 27030-2157 | 2018-06-27 |
| 1366819807 | Tonya Smith Nichols | Nurse Practitioner | 865 W Lake Dr, Mount Airy, NC 27030-2157 | 2015-09-01 |
| 1982037941 | Joanne Minish Garner | Nurse Practitioner | 865 W Lake Dr, Mount Airy, NC 27030-2157 | 2013-08-14 |
| 1447500954 | Jamie Scott Raymond | Nurse Practitioner | 865 W Lake Dr, Mount Airy, NC 27030-2157 | 2012-09-12 |
| 1952610073 | Forsyth Memorial Hospital Inc | Internal Medicine | 865 W Lake Dr, Mount Airy, NC 27030-2102 | 2010-10-07 |
| 1154637585 | Center for Family and Individual Growth, Pa | Social Worker | 865 W Lake Dr, Mount Airy, NC 27030-2157 | 2010-08-23 |
| 1992026579 | Carl Ray Rhoden | Family Medicine | 865 W Lake Dr, Mount Airy, NC 27030-2157 | 2010-06-17 |
| 1336229061 | Heidi Diane Campbell | Physician Assistant | 865 W Lake Dr, Mount Airy, NC 27030-2102 | 2006-10-17 |
| 1790726461 | Thomas Earl Parrish Jr. | Family Medicine | 865 W Lake Dr, Mount Airy, NC 27030-2157 | 2006-06-10 |
| 1295783108 | Forsyth Memorial Hospital, Inc | Family Medicine | 865 W Lake Dr, Mount Airy, NC 27030-2157 | 2006-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124475017 | Jeffrey Lynn Hunter | Podiatrist | 367 S Andy Griffith Pkwy # 200, Mount Airy, NC 27030 | 2016-05-20 |
| 1376984880 | Shari York | Counselor | 847 Westlake Dr, Mount Airy, NC 27030 | 2013-07-12 |
| 1861745069 | Surry-yadkin Residential Services, Inc | Intermediate Care Facility, Mentally Retarded | 1305 Park Dr, Mount Airy, NC 27030 | 2012-10-25 |
| 1346592169 | Debra Lynn Campbell | Physician Assistant | 709 West Independence Blvd., Mount Airy, NC 27030 | 2012-10-03 |
| 1720217680 | Lena Anderson Ferris | Nurse Practitioner | 708 S South St Ste 400, Mount Airy, NC 27030 | 2009-07-13 |
| 1013104520 | Tong Li-masters | Internal Medicine | 830 Rockford Street, Winston Salem, NC 27030 | 2007-09-28 |
| 1336261528 | Thomas R Jackson Dds Pa | Dentist | 1007 Rockford Street, Mount Airy, NC 27030 | 2007-04-06 |
| 1467585422 | Ridgecrest Ritirement Community | Assisted Living Facility | Ridgecrest Retirement, LLC, 1000 Ridgecrest Ln., Mount Airy, NC 27030 | 2007-03-13 |
| 1568516755 | Lou Urmos | Family Medicine | 805 Merita Street, Mt Airy, NC 27030 | 2007-01-23 |
| 1568516391 | Mark Lee Appler | Internal Medicine | 708 S South St Ste 100, Mount Airy, NC 27030 | 2007-01-22 |
| Find all providers in zip 27030 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083273056 | Gaps Health Nc | Family Medicine | 130 Chandler Hills Dr Ste 105, Mount Airy, NC 27030-8805 | 2019-06-12 |
| 1831392174 | Challie A Minton | Family Medicine | 113 Scenic Outlet Ln Ste 2, Mount Airy, NC 27030-9978 | 2007-06-06 |
| 1275636623 | Daniel Joseph Bernstein | Family Medicine | 1908 Caudle Dr, Ste. 100, Mount Airy, NC 27030-4321 | 2006-09-07 |
| 1750351557 | Glenn D Golaszewski | Family Medicine | 401 Technology Ln, Mount Airy, NC 27030-6692 | 2006-01-24 |
| 1457335002 | Vincent V. Miller | Family Medicine | 280 N Pointe Blvd, Mount Airy, NC 27030 | 2005-12-06 |
| 1477546620 | Wake Forest University Baptist Medical Center Community Physicians | Family Medicine | 910 Worth St, Foothills Primary Care, Mount Airy, NC 27030-4458 | 2005-08-23 |
| 1922009190 | Jose R Lopez | Family Medicine | 910 Worth Street, Foothills Primary Care, Mount Airy, NC 27030 | 2005-08-09 |
| 1467450296 | Lawrence Scott Gordon | Family Medicine | 301 Watersville Rd, Mount Airy, MD 21771-5513 | 2005-07-14 |
| 1801890306 | Jose C Acol | Family Medicine | 504 E Ridgeville Blvd Ste 120, Mount Airy, MD 21771-5942 | 2005-06-13 |
| 1144734492 | Kuroush Aligholizadeh | Family Medicine | 2702 Back Acre Cir, Mount Airy, MD 21771-7769 | 2017-11-23 |
| Find all providers in MOUNT AIRY | ||||
| City | MOUNT AIRY |
| Zip Code | 27030 |
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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.