Thomas Clark Kellam

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

2025-02829 Issued in NC

Practice address

200 Robinhood Medical PLZ
Winston Salem, NC 27106-5471

Phone

(336) 718-7950

Fax

(336) 718-7989

NPI assigned

Apr 24, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH, NC2 enrollments

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 2

Specialty

Family PracticeAlso: Sports Medicine

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

Merit-based Incentive Payment System (MIPS)

Final score

82.93 of 100Reported as group

Quality

64.42

Promoting interoperability

99

Improvement activities

40

Cost

73.2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tkellam1060674@direct.osumc.edu
• Direct secure messaging: tkellam445161@direct.novanthealth.org

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.

• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group NPD
• Adena Medical Group LLC

  • Family Medicine Physician
  • Chillicothe, OH
  • NPI 1235468083
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  • Orthopaedic Surgery Physician
  • Charlotte, NC
  • NPI 1558084772
  NPD
• Novant Health Medical Group, LLC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD (past)

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": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1043745375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ROBINHOOD MEDICAL PLZ",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271065471",
            "telephone_number": "336-718-7950",
            "fax_number": "336-718-7989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "272 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Chillicothe",
            "state": "OH",
            "postal_code": "456019031",
            "country_code": "US",
            "telephone_number": "740-779-4598",
            "fax_number": "740-779-4599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLAM",
        "first_name": "THOMAS",
        "middle_name": "CLARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-24",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2025-02829",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "OH",
            "license": "35.143319",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NC",
            "license": "2025-02829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0459528",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adena.abjc@adena.medicity.net",
            "affiliation": "N",
            "address_1": "272 Hospital Rd",
            "city": "Chillicothe",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456019031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Philip David Keith, MD
• Anita A. Kelkar, M.D/M.P.H.
• Leslie Kellam, DNP
• Lori Goco Kellam, MD
• Molly Kellam, FNP-C
• Amber Brewer Keller, PA-C
• Calvin Woodrow Keller, LAT-ATC
• Jennifer Keller, FNP
• Tiffany Keller, NP
• Amber Smoot Kelley, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; 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.