Keith Bergen Van Zandt, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

31215 Issued in NC

Practice address

Robinhood Medical Plaza
BLDG 100
Winston-Salem, NC 27106

Phone

(336) 718-0800

Fax

(336) 718-0871

NPI assigned

Apr 4, 2006

Last updated

Apr 26, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kvanzandt16152@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Forsyth Memorial Hospital, Inc.

  dba NH Forsyth Primary Care Clinics

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1104548874
  Medicare reassignment NPD
• Forsyth Memorial Hospital Inc

  dba Novant Health Maplewood Family Medicine

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1942258843
  NPD
• Forsyth Memorial Hospital, Inc.

  dba Novant Health Heart & Vascular Institute - Frontis Plaza

  • Cardiovascular Disease Physician
  • Winston Salem, NC
  • NPI 1932935475
  NPD

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1053373332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-718-4820",
            "fax_number": "704-384-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROBINHOOD MEDICAL PLAZA",
            "address_2": "BLDG 100",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27106",
            "telephone_number": "336-718-0800",
            "fax_number": "336-718-0871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN ZANDT",
        "first_name": "KEITH",
        "middle_name": "BERGEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "31215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7984784",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kvanzandt16152@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "Robinhood Medical Plaza",
            "address_2": "Bldg 100",
            "city": "Winston-Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "27106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Valerie Benton Center
• Kanthimayi Valety
• Rebecca S. Valla, M.D.
• Amanda Katherine Van Emburgh, PSYD
• Alana Eriksen Van Schaick
• Laura M Vance, PHARMD
• Edward Roy Vanderbilt, MSN, APRN, FNP-C
• Patty Susan Vandergrift, RN, NNP-BC
• Courtney Marie Vandermeersch, MD
• Sarah Vanderpool, LCMHC, NCC, LPSC

• 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 Apr 26, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.