Individual provider Active NPI

Katherine Farris, M.D.

  • Family Medicine Physician
  • Winston Salem, NC
National Provider Identifier
1013988989
Registry record updated Sep 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2009-00506 Issued in NC
Practice address
3000 Maplewood Ave
Suite 112
Winston Salem, NC 27103-4002
Phone
(336) 768-2980
Fax
(336) 765-6599
NPI assigned
Jan 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 217062 MA
Family Medicine Physician 207Q00000X 2009-00506 NC Primary

Addresses

Primary practice location

3000 Maplewood Ave
Suite 112
Winston Salem, NC 27103-4002

Mailing address

100 S Boylan Ave
Raleigh, NC 27603-1802
Phone (919) 833-7534

Other identifiers 1

IdentifierTypeStateIssuer
2017661MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2009-00506NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood South Atlantic Past Accepting new patients
Planned Parenthood South Atlantic Past Accepting new patients
Planned Parenthood South Atlantic Past Accepting new patients
Planned Parenthood Health Systems, Inc Past Accepting new patients
Heywood Medical Group Inc. Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: katherine.farris.p12@direct.bhplannedparenthood.nextgenshare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378339200000",
    "number": "1013988989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S BOYLAN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276031802",
            "telephone_number": "919-833-7534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MAPLEWOOD AVE",
            "address_2": "SUITE 112",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034002",
            "telephone_number": "336-768-2980",
            "fax_number": "336-765-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRIS",
        "first_name": "KATHERINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2013-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "217062",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2009-00506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2017661",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.