FORSYTH MEDICAL HOSPITAL, INC (NPI# 1508046053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508046053 |
| Entity Type | Organization |
| Organization Name | FORSYTH MEDICAL HOSPITAL, INC |
| Other Organization Name | WINSTON-SALEM HEALTHCARE |
| Practice Address |
175 Kimel Park Dr Dba Winston-salem Healthcare Winston Salem NC 27103-6951 |
| Mailing Address |
2000 Frontis Plaza Blvd Ste 200 Winston Salem NC 27103-5616 |
| Practice Telephone | 3367181006 |
| Mailing Telephone | 3362772435 |
| Mailing Fax Number | 3362779275 |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2007-11-13 |
| Authorized Official Name | PATRICK EASTERLING (COO & EXECUTIVE VP) |
| Authorized Official Telephone | 7043849094 |
| Is Organization Subpart | Y |
| Parent Organization Name | FORSYTH MEDICAL HOSPITAL, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS GRP # | 0294Y | 01 |
| NC | 590118P | 05 |
| Other Name | Type Code |
|---|---|
| Winston-Salem Healthcare | Doing Business As Name - Organization |
| Street Address |
175 KIMEL PARK DR DBA WINSTON-SALEM HEALTHCARE |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-6951 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174524979 | Michael L Pool | Psychiatry & Neurology | 175 Kimel Park Dr, Suite 100, Winston Salem, NC 27103-6951 | 2005-08-03 |
| 1497297584 | Christie Nelson | Counselor | 175 Kimel Park Dr, Suite 100, Winston Salem, NC 27103-6951 | 2016-11-07 |
| 1578959755 | Emily Hix Dothard | Dermatology | 175 Kimel Park Dr, Winston Salem, NC 27103-6951 | 2015-04-14 |
| 1245630128 | Cumi Bevel | Social Worker | 175 Kimel Park Dr, Suite 100, Winston Salem, NC 27103-6951 | 2014-08-28 |
| 1831524933 | Stewart Kepley Austin | Social Worker | 175 Kimel Park Dr, Suite 100, Winston Salem, NC 27103-6951 | 2013-09-08 |
| 1760752638 | Lashanda M King-jones | Counselor | 175 Kimel Park Dr, Suite 100, Winston Salem, NC 27103-6951 | 2012-01-09 |
| 1043503287 | Novant Medical Group, Inc | Psychiatry & Neurology | 175 Kimel Park Dr, Suite 100, Winston Salem, NC 27103-6951 | 2011-05-20 |
| 1417271313 | Forsyth Memorial Hospital, Inc | Family Medicine | 175 Kimel Park Dr, Winston Salem, NC 27103-6951 | 2010-03-22 |
| 1093943599 | Jessica Cipoletti Derreberry | Psychiatry & Neurology | 175 Kimel Park Dr, Winston Salem, NC 27103-6951 | 2009-06-23 |
| 1346427200 | Forsyth Memorial Hospital Inc | Psychiatry & Neurology | 175 Kimel Park Dr, Suite 100, Winston Salem, NC 27103-6951 | 2008-01-23 |
| 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 | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982067120 | Jacquelyn Marjorie Majerowski | Dermatology | Department of Pathology Medical Center Boulevard, Winston Salem, NC 27157-4330 | 2016-04-04 |
| 1588077747 | Christine Ahn | Dermatology | 300 Medical Center Blvd, Winston Salem, NC 27157-0003 | 2014-06-05 |
| 1437379476 | Wesley Raymond Hawfield | Dermatology | 175 Kimel Park Drive, Winston Salem, NC 27103-1508 | 2007-05-01 |
| 1164573226 | Sarah L Taylor | Dermatology | 4618 Country Club Road, Wake Forest Baptist Health Medical Plaza, Winston Salem, NC 27104-3520 | 2007-01-16 |
| 1699836908 | Triad Dermatology Pa | Dermatology | 725 Highland Oaks Drive, Suite 106, Winston Salem, NC 27103 | 2006-12-12 |
| 1578675179 | Anne L White | Dermatology | 1255 Creekshire Way Ste 290, Winston Salem, NC 27103-3061 | 2006-08-31 |
| 1649237082 | Skin Surgery Center Pa | Dermatology | 1450 Professional Park Dr, Suite 150, Winston Salem, NC 27103-1300 | 2006-04-28 |
| 1720063175 | Steven Richard Feldman | Dermatology | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2005-12-08 |
| 1497756647 | Alan D Klein | Dermatology | 2020 Peace Haven Rd, Winston Salem, NC 27106-4851 | 2005-08-09 |
| 1932108461 | Paul Douglass Wortman | Dermatology | 127 S Poplar St, Winston Salem, NC 27101-3755 | 2005-07-18 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
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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.