Provider Demographics
NPI:1124070115
Name:ORTHOPAEDIC SPECIALISTS OF THE CAROLINAS, P.A.
Entity type:Organization
Organization Name:ORTHOPAEDIC SPECIALISTS OF THE CAROLINAS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-659-4111
Mailing Address - Street 1:PO BOX 25626
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27114-5626
Mailing Address - Country:US
Mailing Address - Phone:336-768-1270
Mailing Address - Fax:336-765-6375
Practice Address - Street 1:170 KIMEL PARK DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-6946
Practice Address - Country:US
Practice Address - Phone:336-768-1270
Practice Address - Fax:336-765-6375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC27080OtherBLUE MEDICARE NUMBER
NC890110QMedicaid
NC0110QOtherBCBS GROUP NUMBER
NCCN4910OtherRR MEDICARE GROUP #
NCCD6584OtherRR MEDICARE GROUP #
NC0110QOtherBCBS GROUP NUMBER
NC1150820001Medicare NSC
NCCD6584OtherRR MEDICARE GROUP #
NC890110QMedicaid