Individual provider Active NPI

Zachary W Sandbulte, MD

  • Sports Medicine (Family Medicine) Physician
  • Winston Salem, NC
National Provider Identifier
1063739100
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
2013-01052 Issued in NC
Practice address
200 Robinhood Medical PLZ
Winston Salem, NC 27106
Phone
(336) 718-7950
NPI assigned
Apr 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 2013-01052 NC Primary

Addresses

Primary practice location

200 Robinhood Medical PLZ
Winston Salem, NC 27106

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

200 Robinhood Medical Plz
Winston Salem, NC 27106
Phone (336) 718-7950

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address zsandbulte190511@direct.novanthealth.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150303001535 NC Practitioner - Sports MedicinePractitioner - Family PracticePractitioner - Gastroenterology 0446576797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Other, 2010
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)

167 Moore Rd
King, NC 27021-8770

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

5145 Sellers Rd
Shallotte, NC 28470-3405
Phone (910) 754-4572

7210 Village Medical Cir
Clemmons, NC 27012-8029

Hospital & facility affiliations

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Oct 19, 2016 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Oct 19, 2016 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

4741 Randolph Rd
#100
Charlotte, NC 28211
Phone (704) 365-6730

7210 Village Medical Cir
Ste 110
Clemmons, NC 27012
Phone (336) 893-2400

1622 Highwoods Blvd
Unit G105
Greensboro, NC 27410
Phone (336) 660-5200

6431 Old Plank Rd
High Point, NC 27265
Phone (336) 875-6530

1730 Kernersville Medical Pkwy
Ste 204
Kernersville, NC 27284
Phone (336) 277-4460

167 Moore Rd
Ste 202
King, NC 27021
Phone (336) 673-6500

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

211 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-1191

200 Robinhood Medical Plz
Winston Salem, NC 27106
Phone (336) 718-7950

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1063739100",
    "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": "27106",
            "telephone_number": "336-718-7950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Robinhood Medical Plz",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "27106",
            "country_code": "US",
            "telephone_number": "336-718-7950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDBULTE",
        "first_name": "ZACHARY",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-29",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NC",
            "license": "2013-01052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zsandbulte190511@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "200 Robinhood Medical Plz",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "27106",
            "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.