Nancy Alexis Nifong, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2015-01766 Issued in NC

Practice address

5350 S Main St
Winston Salem, NC 27107-9174

Phone

(336) 784-0505

Fax

(336) 784-5031

NPI assigned

Mar 28, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Alexis Fulk Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cedar Creek Family Medicine PLLCGroup PAC ID 4880869338, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: afulk161749@direct.novanthealth.org
• Direct secure messaging: fulk.alexis.1@11229.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/11229/brand/1/csg/1/fhir/r4

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.

• Cedar Creek Family Medicine PLLC

  • Primary Care Clinic/Center
  • Winston Salem, NC
  • NPI 1952579807
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Forsyth Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1447200233
  Care Compare affiliation

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1043586605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 S MAIN ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271079174",
            "telephone_number": "336-784-0505",
            "fax_number": "336-784-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 S MAIN ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271079174",
            "telephone_number": "336-784-0505",
            "fax_number": "336-784-5031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIFONG",
        "first_name": "NANCY",
        "middle_name": "ALEXIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2015-01766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Athena",
            "affiliation": "N",
            "endpointDescription": "Athena",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Athena",
            "address_1": "5350 S Main St",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271079174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "FULK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Patricia C Nielsen, NP
• Devon Joseph Niewohner, DPM
• Christian Ross Nifong
• Deborah H Nifong
• Kylie Elizabeth Nifong
• Ted James Nifong, MD
• Carley Rudiger Niland, LCMHC
• Scott Joseph Bellamy Nimmons, MD
• Joshua Franklin Nitsche, M.D., PHD
• Karla Nitschke, PTA

• Family Medicine Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.