=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942359385
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORTH CAROLINA BAPTIST HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2007
-----------------------------------------------------
Last Update Date | 09/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | MEDICAL CENTER BLVD
-----------------------------------------------------
City | WINSTON SALEM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27157-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-713-0277
-----------------------------------------------------
Fax | 336-716-6705
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | MEDICAL CENTER BLVD
-----------------------------------------------------
City | WINSTON SALEM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27157-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-716-3539
-----------------------------------------------------
Fax | 336-716-3153
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT, WAKE FOREST BAPTIST MC
-----------------------------------------------------
Name | CATHLEEN WHEATLEY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 336-716-8021
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | 1365
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------