Individual provider Active NPI

Jennifer Rasch

  • Family Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1043628969
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5007020 Issued in NC
Practice address
3815 Forrestgate Dr
Winston Salem, NC 27103-2930
Phone
(336) 930-9600
Fax
(336) 930-9930
NPI assigned
Jul 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5007020 NC Primary

Addresses

Primary practice location

3815 Forrestgate Dr
Winston Salem, NC 27103-2930

Mailing address

930 3Rd St
Greensboro, NC 27405-6967
Phone (336) 890-3200

Other practice location 1

801 Green Valley Rd
Greensboro, NC 27408-7021
Phone (336) 832-6614

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jrasch12598@direct.conehealth.com Direct

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141007000158 NC Practitioner - Nurse Practitioner 0446470892 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1635 NC Hwy 66 S 175
Kernersville, NC 27284-3705
Phone (336) 993-6120

1635 NC Hwy 66 S 210
Kernersville, NC 27284-3705
Phone (336) 992-1770

501 N Elam Ave
Greensboro, NC 27403-1118
Phone (336) 832-0110

509 D N Elam Ave
Greensboro, NC 27403-1118
Phone (336) 832-0970

509 DN Elam Ave
Greensboro, NC 27403-1118
Phone (336) 832-0970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5007020NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Aug 10, 2014 Accepting new patients
Mertz MFM Center CurrentSince Sep 6, 2023 Accepting new patients
The Moses H. Cone Memorial Hospital Operating Corporation Past Accepting new patients

Locations

3711 Elmsley St
Ste 101
Greensboro, NC 27406
Phone (336) 890-2165

300 E Wendover Ave
Greensboro, NC 27401
Phone (336) 663-5205

930 3rd St
Greensboro, NC 27405
Phone (336) 610-3720

801 Green Valley Rd
Greensboro, NC 27408
Phone (336) 282-4840

802 Green Valley Rd
Ste 200
Greensboro, NC 27408
Phone (336) 370-0277

2400 W Friendly Ave
Greensboro, NC 27403
Phone (336) 832-1100

1635 NC Highway 66 S
Ste 245
Kernersville, NC 27284
Phone (336) 992-5120

3815 Forrestgate Dr
Winston Salem, NC 27103
Phone (336) 480-4173

1048 Terrace Dr
Marion, VA 24354
Phone (276) 477-4246

Interoperability endpoints

  • Direct secure messaging: jrasch12598@direct.conehealth.com

Organizations & group practices 3

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": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1043628969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 3RD ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056967",
            "telephone_number": "336-890-3200",
            "fax_number": "336-890-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 FORRESTGATE DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032930",
            "telephone_number": "336-930-9600",
            "fax_number": "336-930-9930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Green Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274087021",
            "country_code": "US",
            "telephone_number": "336-832-6614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RASCH",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-23",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5007020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrasch12598@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health Direct Message",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "930 3rd St",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274056967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.