Provider Demographics
NPI:1184600264
Name:CARESS, JAMES BAYARD (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:BAYARD
Last Name:CARESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 344
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27102-0344
Mailing Address - Country:US
Mailing Address - Phone:336-716-2255
Mailing Address - Fax:336-716-9016
Practice Address - Street 1:MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-716-2255
Practice Address - Fax:336-716-9016
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96004782084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8921113Medicaid
NC19173OtherPARTNERS
VA6104312Medicaid
NC65770OtherMEDCOST
NC7363815OtherAETNA
WV9801214000Medicaid
NC21113OtherBLUE CROSS
SCQ00478Medicaid
NC65770OtherMEDCOST
G11677Medicare UPIN