MEDICARE: PLANNED PARENTHOOD SOUTH ATLANTIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0005X	Ambulatory Family Planning Facility
2	363LW0102X	Women's Health Nurse Practitioner

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689711632
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANNED PARENTHOOD SOUTH ATLANTIC

Provider Business Mailing Address
First Line	:	100 S BOYLAN AVE
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27603-1802
Country	:	US
Telephone Number	:	919-833-7534
Fax Number	:	919-833-0730

Provider Business Practice Location Address
First Line	:	3010 MAPLEWOOD AVE
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-4019
Country	:	US
Telephone Number	:	336-768-2980
Fax Number	:	336-765-6599

Authorized Official
Title or Position	:	CFO
Name	:	KARL LEVILLE
Credential	:
Telephone Number	:	919-833-7526

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	09/08/2025

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Directions to “PLANNED PARENTHOOD SOUTH ATLANTIC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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