Individual provider Active NPI

Bernice Badu, MD

  • General Practice Physician
  • Winston Salem, NC
National Provider Identifier
1083291074
Registry record updated Dec 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
2023-03371 Issued in NC
Practice address
1 Medical Center Blvd 5TH Janeway Tower
Winston Salem, NC 27157-0001
Phone
(336) 716-0423
NPI assigned
Mar 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 2023-03371 NC Primary

Addresses

Primary practice location

1 Medical Center Blvd 5TH Janeway Tower
Winston Salem, NC 27157-0001

Mailing address

1 Medical Center Blvd 5TH Janeway Tower
Winston Salem, NC 27157-0001
Phone (336) 716-0423

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
I20250905000183 NC Practitioner - General Practice 4082015318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Medical College of Wisconsin, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9425 Delegates Row
Indianapolis, IN 46240-3805

PO Box
Suite 12341
Winston Salem, NC 27117

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023-03371NCMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Health Centers CurrentSince May 1, 2025 Accepting new patients
United Health Center CurrentSince May 1, 2025 Accepting new patients

Locations

3009 Waughtown St
Winston Salem, NC 27107
Phone (336) 293-8728

2101 Peters Creek Pkwy
Ste 1619
Winston Salem, NC 27127
Phone (336) 293-8728

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AIBJAD

Organizations & group practices 2

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": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702771200000",
    "number": "1083291074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD 5TH JANEWAY TOWER",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-0423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD 5TH JANEWAY TOWER",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADU",
        "first_name": "BERNICE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-25",
        "last_updated": "2023-12-17",
        "certification_date": "2023-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "2023-03371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.