| Forsyth Community Pcc Llc | |
|
650 Highland Ave Ste 120 Winston Salem NC 27101-4304 | |
| (336) 718-4770 | |
| (336) 718-4779 |
| Full Name | Forsyth Community Pcc Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 650 Highland Ave Ste 120, Winston Salem, North Carolina |
| Authorized Official Name and Position | Leea Jeanine Walton (RCS MANAGER) |
| Authorized Official Contact | 7043166081 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Forsyth Community Pcc Llc Po Box 603582 Charlotte NC 28260-3582 Ph: () - | Forsyth Community Pcc Llc 650 Highland Ave Ste 120 Winston Salem NC 27101-4304 Ph: (336) 718-4770 |
| NPI Number | 1730670951 |
|---|---|
| Provider Enumeration Date | 05/23/2018 |
| Last Update Date | 07/12/2023 |
| Medicare PECOS PAC ID | 4486908316 |
|---|---|
| Medicare Enrollment ID | O20181113001654 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730670951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Carmen G Strickland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659354207 PECOS PAC ID: 9537126776 Enrollment ID: I20041220000291 |
| Provider Name | Lisa A Cassidy-vu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093763351 PECOS PAC ID: 1951347921 Enrollment ID: I20050629000947 |
| Provider Name | Angela Muller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013958115 PECOS PAC ID: 1951337724 Enrollment ID: I20080130000682 |
| Provider Name | Richard W Lord |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346224854 PECOS PAC ID: 8921143462 Enrollment ID: I20100308000829 |
| Provider Name | Ann Hiott Barham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336123751 PECOS PAC ID: 8224173794 Enrollment ID: I20100309000123 |
| Provider Name | John G Spangler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063496461 PECOS PAC ID: 6305971185 Enrollment ID: I20100318000394 |
| Provider Name | Mark P Knudson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073597035 PECOS PAC ID: 3476689209 Enrollment ID: I20100331000142 |
| Provider Name | Neil Leslie Sparks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710113733 PECOS PAC ID: 0042444994 Enrollment ID: I20131008000403 |
| Provider Name | Lourdes Cu Ramos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568890705 PECOS PAC ID: 1052541562 Enrollment ID: I20140303000596 |
| Provider Name | Keli B Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124313051 PECOS PAC ID: 8628296746 Enrollment ID: I20140902000800 |
| Provider Name | Kaitlyn Anne Watson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437596574 PECOS PAC ID: 7517197502 Enrollment ID: I20160719002361 |
| Provider Name | Rachel Katherine Fesperman Woodruff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154647519 PECOS PAC ID: 5597999235 Enrollment ID: I20170915001175 |
| Provider Name | Elizabeth W Mumaw |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841605979 PECOS PAC ID: 9537465844 Enrollment ID: I20171113001180 |
| Provider Name | Brett A Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497174817 PECOS PAC ID: 1951616507 Enrollment ID: I20180314002287 |
| Provider Name | Loray A Blair Britt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932191400 PECOS PAC ID: 0042262198 Enrollment ID: I20191113001699 |
| Provider Name | Heather Strickland Perry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912591280 PECOS PAC ID: 3375950546 Enrollment ID: I20210406001195 |
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