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OLD TOWN FAMILY MEDICINE, P A
NPI 1447370101
Clinic/Center in Winston Salem, NC

Active since March 29, 2007
3690 REYNOLDA RD, WINSTON SALEM, NC 27106(336) 922-1363 Get Directions Write a Review

NPPES record last updated: January 26, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Old Town Family Medicine, P A NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OLD TOWN FAMILY MEDICINE, P A (NPI 1447370101) is a healthcare organization registered as a clinic/center in Winston Salem, North Carolina and active in the NPI registry since March 2007. The organization lists Richard Ray Herber, President, as its authorized official.

NPPES Registry Identity

NPI1447370101
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameOLD TOWN FAMILY MEDICINE, P A
Location Address3690 REYNOLDA RDWinston Salem, NC 27106-2230
Mailing Address3690 Reynolda RdWinston Salem, NC 27106-2230 · (336) 922-1363
Phone(336) 922-1363
Organization SubpartNo
Authorized OfficialRichard Ray HerberPresident · (336) 922-1363
Enumeration DateMarch 29, 2007
Last NPPES UpdateJanuary 26, 2012
✔ NPI 1447370101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in NC · 39614
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
3690 REYNOLDA RD, Winston Salem, NC 27106
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Other Identifiers 3

Medicare UPINE64612NC
Medicaid8941873NC
Medicare ID-Type Unspecified2346254NC

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OLDTOWN IMMEDIATE CARE, PA
Family Medicine
3690 REYNOLDA RD
WINSTON SALEM, NC 27106
Forsyth County (336) 922-1363

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Old Town Family Medicine, P A's NPI number?

The NPI number for Old Town Family Medicine, P A is 1447370101. It was assigned to this organization in the NPPES registry on March 29, 2007.

Where is Old Town Family Medicine, P A located?

Old Town Family Medicine, P A is located at 3690 Reynolda Rd, Winston Salem, NC 27106. The listed phone number is (336) 922-1363.

What is Old Town Family Medicine, P A's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Old Town Family Medicine, P A was last updated on January 26, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.