| Old Vineyard Physician Group | |
|
3637 Old Vineyard Rd Winston Salem NC 27104 | |
| (336) 794-3550 | |
| (336) 794-4339 |
| Full Name | Old Vineyard Physician Group |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3637 Old Vineyard Rd, Winston Salem, North Carolina |
| Authorized Official Name and Position | Steve Filton (VICE PRESIDENT) |
| Authorized Official Contact | 6107683300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Old Vineyard Physician Group 3637 Old Vineyard Rd Winston Salem NC 27104-4842 Ph: (336) 794-3550 | Old Vineyard Physician Group 3637 Old Vineyard Rd Winston Salem NC 27104 Ph: (336) 794-3550 |
| NPI Number | 1780817452 |
|---|---|
| Provider Enumeration Date | 08/28/2009 |
| Last Update Date | 09/04/2018 |
| Medicare PECOS PAC ID | 2567466386 |
|---|---|
| Medicare Enrollment ID | O20091030000579 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780817452 | NPI | - | NPPES |
| 5912567 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MHH0188 (North Carolina) | Primary |
| Provider Name | Barry N Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366409914 PECOS PAC ID: 7618868852 Enrollment ID: I20040408000765 |
| Provider Name | Keshavpal Gunna Reddy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942269766 PECOS PAC ID: 5092757617 Enrollment ID: I20050524001072 |
| Provider Name | Nadeem Akhtar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912914300 PECOS PAC ID: 8123056678 Enrollment ID: I20050727000392 |
| Provider Name | Halimena Montclaire Creque |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487634507 PECOS PAC ID: 8426195777 Enrollment ID: I20091020000217 |
| Provider Name | Gisela E Knebl Kohl |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922217306 PECOS PAC ID: 8224176342 Enrollment ID: I20091110000804 |
| Provider Name | William Yarborough Carlton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194833517 PECOS PAC ID: 6800054198 Enrollment ID: I20120215000667 |
| Provider Name | Tayyba G Buttar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972737922 PECOS PAC ID: 2365692860 Enrollment ID: I20121018000191 |
| Provider Name | Jagannath Subedi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245521343 PECOS PAC ID: 2860709383 Enrollment ID: I20150916001540 |
| Provider Name | Lisa M Waye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043869746 PECOS PAC ID: 0547674319 Enrollment ID: I20210208000734 |
Disability Advocacy And Information Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8064 N Point Blvd, Suite 102, Winston Salem, NC 27106 Phone: 336-896-0900 Fax: 336-896-0901 | |
Lyfes New Direction Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1001 S Marshall St # 65, Winston Salem, NC 27101 Phone: 336-721-4261 Fax: 336-721-4265 | |
Evolve Care Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 897 Peters Creek Pkwy Ste 101, Winston Salem, NC 27103 Phone: 336-725-9135 Fax: 336-725-9139 | |
Pinnacle Family Services Of North Carolina Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4035 University Pkwy, Ste 101, Winston Salem, NC 27106 Phone: 336-397-1560 | |
Managing Overwhelming Moments, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1119 Stafford Place Cir Apt 103, Winston Salem, NC 27127 Phone: 919-218-6286 | |
Alexander Youth Network Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8025 N Point Blvd Ste 260, Winston Salem, NC 27106 Phone: 336-724-1412 Fax: 336-724-1464 | |
Daymark Recovery Services Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 651 Highland Ave, Winston Salem, NC 27101 Phone: 336-657-8523 Fax: 336-723-0645 |