| Guilford Child Health-wendover | |
|
1046 E Wendover Ave Greensboro NC 27405-6712 | |
| (336) 272-1050 | |
| (336) 272-0155 |
| Full Name | Guilford Child Health-wendover |
|---|---|
| Speciality | Clinic/Center |
| Location | 1046 E Wendover Ave, Greensboro, North Carolina |
| Authorized Official Name and Position | Brian K Ellerby (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3362721050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Guilford Child Health-wendover 1046 E Wendover Ave Greensboro NC 27405-6712 Ph: (336) 272-1050 | Guilford Child Health-wendover 1046 E Wendover Ave Greensboro NC 27405-6712 Ph: (336) 272-1050 |
| NPI Number | 1598762940 |
|---|---|
| Provider Enumeration Date | 06/30/2005 |
| Last Update Date | 08/29/2011 |
| Medicare PECOS PAC ID | 1850311986 |
|---|---|
| Medicare Enrollment ID | O20051202000722 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598762940 | NPI | - | NPPES |
| 2348638A | Other | NC | MEDICARE |
| 890244U | Medicaid | NC | |
| 0244U | Other | NC | BCBS OF NC |
| 34D0926152 | Other | NC | CLIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Rebecca S Parrish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467487629 PECOS PAC ID: 0143128306 Enrollment ID: I20031229000348 |
| Provider Name | Kathleen E Zeller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386798171 PECOS PAC ID: 3274633532 Enrollment ID: I20070716000450 |
| Provider Name | Kelly L Vollmer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639220841 PECOS PAC ID: 0345332128 Enrollment ID: I20070824000215 |
| Provider Name | Melanie Joy Martin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598843518 PECOS PAC ID: 9638248743 Enrollment ID: I20080515000291 |
| Provider Name | Eric Dean |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154383461 PECOS PAC ID: 4789759598 Enrollment ID: I20080813000500 |
| Provider Name | Tamika Jo Lott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386791879 PECOS PAC ID: 3678633591 Enrollment ID: I20081122000180 |
| Provider Name | Sheri D Lim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881628121 PECOS PAC ID: 3870625239 Enrollment ID: I20100720000921 |
| Provider Name | Michelle F Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194039164 PECOS PAC ID: 0345433827 Enrollment ID: I20101015000778 |
| Provider Name | Enobong Newlin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548429343 PECOS PAC ID: 1254596349 Enrollment ID: I20120621000657 |
| Provider Name | Graham Henry Erlacher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003999780 PECOS PAC ID: 9830183508 Enrollment ID: I20121231000015 |
| Provider Name | Gretchen F Jacox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760764500 PECOS PAC ID: 8628217569 Enrollment ID: I20130625000485 |
| Provider Name | John S Mitchell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558463471 PECOS PAC ID: 4587602917 Enrollment ID: I20130702000609 |
| Provider Name | Chara C Freeman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679749253 PECOS PAC ID: 8921278748 Enrollment ID: I20131210000203 |
| Provider Name | Sylvia R Mand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649407396 PECOS PAC ID: 8123154812 Enrollment ID: I20141020001922 |
| Provider Name | Amy E Coe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053767244 PECOS PAC ID: 7810281938 Enrollment ID: I20160811001386 |
| Provider Name | Ying Marshall |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1528443231 PECOS PAC ID: 8527353077 Enrollment ID: I20160823000363 |
| Provider Name | Adolf V Malik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013369420 PECOS PAC ID: 8325329550 Enrollment ID: I20170103000017 |
| Provider Name | Tanika Niko Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538616263 PECOS PAC ID: 8628359619 Enrollment ID: I20170105002329 |
| Provider Name | Daphnee Pierre Louis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043612997 PECOS PAC ID: 5597069955 Enrollment ID: I20170124001150 |
| Provider Name | Denise Nicole Hunter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538296561 PECOS PAC ID: 7719160209 Enrollment ID: I20170213000606 |
| Provider Name | Romana Sevcikova Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811435423 PECOS PAC ID: 2668759382 Enrollment ID: I20170508000599 |
| Provider Name | Carmen Tabrielle Robinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609118462 PECOS PAC ID: 7113218660 Enrollment ID: I20171024003713 |
| Provider Name | Sarrin E List |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225408875 PECOS PAC ID: 6406117670 Enrollment ID: I20180305000106 |
| Provider Name | Daniel K Ntibrey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306312327 PECOS PAC ID: 9537408117 Enrollment ID: I20190226000589 |
| Provider Name | Alvesha A Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043860471 PECOS PAC ID: 9335573849 Enrollment ID: I20191216001838 |
| Provider Name | Wendy Scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023209996 PECOS PAC ID: 0446681001 Enrollment ID: I20200514001539 |
| Provider Name | Christian Ashley Jasper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629598032 PECOS PAC ID: 7315212883 Enrollment ID: I20201221001503 |
| Provider Name | Stephanie N Lane |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689042319 PECOS PAC ID: 9436568466 Enrollment ID: I20210504001862 |
| Provider Name | Rikki C Cruz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265029714 PECOS PAC ID: 2668872847 Enrollment ID: I20210609001578 |
| Provider Name | Ralph Howard Newman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730623182 PECOS PAC ID: 2062804917 Enrollment ID: I20220126002140 |
| Provider Name | Meaghan C Whitson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295072684 PECOS PAC ID: 9638561426 Enrollment ID: I20220128001928 |
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