| Quick Doc Nc, Pa | |
|
3734 Reynolda Rd Winston Salem NC 27106-2240 | |
| (336) 922-1102 | |
| (336) 922-5012 |
| Full Name | Quick Doc Nc, Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 3734 Reynolda Rd, Winston Salem, North Carolina |
| Authorized Official Name and Position | Henry Franklin Tripp (DIRECTOR) |
| Authorized Official Contact | 3369933146 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Quick Doc Nc, Pa 3734 Reynolda Rd Winston Salem NC 27106-2240 Ph: (336) 922-1102 | Quick Doc Nc, Pa 3734 Reynolda Rd Winston Salem NC 27106-2240 Ph: (336) 922-1102 |
| NPI Number | 1659490597 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 10/08/2020 |
| Medicare PECOS PAC ID | 2567500226 |
|---|---|
| Medicare Enrollment ID | O20091117000631 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659490597 | NPI | - | NPPES |
| 40655 | Other | NC | MEDICAL BOARD |
| 5922000 | Medicaid | NC | |
| 01791 | Other | NC | BLS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | 40655 (North Carolina) | Primary |
| Provider Name | Henry F Tripp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104829142 PECOS PAC ID: 4587613179 Enrollment ID: I20050120001052 |
| Provider Name | Paige Marie Motsinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255825477 PECOS PAC ID: 7113274994 Enrollment ID: I20180725001219 |
| Provider Name | Mark Randolph Jularbal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720547771 PECOS PAC ID: 2567705593 Enrollment ID: I20190515000921 |
| Provider Name | Kelly N Triplett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902400443 PECOS PAC ID: 7012320435 Enrollment ID: I20210104001016 |
| Provider Name | Dustin Lee Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902416258 PECOS PAC ID: 5294148649 Enrollment ID: I20210105000181 |
| Provider Name | Edward Roy Vanderbilt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417553942 PECOS PAC ID: 8729495502 Enrollment ID: I20210323000222 |
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