OrganizationActive
Club Haven Family Practice
NPI 1902869829 · Specialist · Winston-Salem, NC
Club Haven Family Practice is a Specialist organization in Winston-Salem, NC (NPI 1902869829).
Provider details
- NPI number
- 1902869829
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Organization subpart
- No
- Authorized official
- Thomas Jolly, Owner(336) 768-9575
- License
- 40378/30659 (NC)
Specialties & taxonomies
Other Service Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2801 Lyndhurst Ave
Winston-Salem, NC 27103-4109
Phone: (336) 768-9575
Fax: (336) 774-1737
Street-level locationGet directions
Mailing address
2801 Lyndhurst Ave
Winston-Salem, NC 27103-4109
Registry dates
- Enumerated
- 2006-04-11
- Last updated
- 2020-08-22
Frequently asked questions
- What is Club Haven Family Practice's NPI number?
- Club Haven Family Practice's National Provider Identifier (NPI) is 1902869829, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Club Haven Family Practice?
- Club Haven Family Practice is classified in the NPPES registry as Specialist (Other Service Providers).
- Where is Club Haven Family Practice located?
- Club Haven Family Practice's practice location on file with NPPES is 2801 Lyndhurst Ave, Winston-Salem, NC 27103-4109.
- What is Club Haven Family Practice's phone number?
- The practice phone number listed in the NPPES registry for Club Haven Family Practice is (336) 768-9575.
- Who is the authorized official for Club Haven Family Practice?
- The authorized official listed on Club Haven Family Practice's NPPES record is Thomas Jolly, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Club Haven Family Practice's NPI active?
- Yes — Club Haven Family Practice's NPI (1902869829) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.