Provider Demographics
NPI:1699839480
Name:WINCARE CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:WINCARE CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:WINYARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:336-248-8402
Mailing Address - Street 1:204 FAIR OAKS LN
Mailing Address - Street 2:
Mailing Address - City:WINSTON-SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127
Mailing Address - Country:US
Mailing Address - Phone:336-248-8402
Mailing Address - Fax:336-893-9511
Practice Address - Street 1:204 FAIR OAKS LN
Practice Address - Street 2:
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27127
Practice Address - Country:US
Practice Address - Phone:336-248-8402
Practice Address - Fax:336-893-9511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08940OtherBCBS GROUP NUMBER
NC10143OtherPARTNERS ID NUMBER
NC08947OtherBCBS INDY NUMBER
NC8908947Medicaid
NC08940OtherBCBS GROUP NUMBER
NC2449351Medicare ID - Type UnspecifiedMEDICARE ID NUMBER