NPIMap

Individual provider Active NPI

Melissa R Smith, PA-C

  • Medical Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1083885610
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
001001297 Issued in NC
Practice address
1 Medical Center Blvd
Winston Salem, NC 27157-0001
Phone
(336) 713-4240
Fax
(336) 716-6127
NPI assigned
Mar 24, 2008
Last updated
Mar 20, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-01297 NC
Medical Physician Assistant 363AM0700X 001001297 NC Primary

Addresses

Primary practice location

1 Medical Center Blvd
Winston Salem, NC 27157-0001

Mailing address

714 Carneros Cir
High Point, NC 27265-9485
Phone (336) 577-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130124000305 NC Practitioner - Physician Assistant 0244484335 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001001297NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jul 20, 2015 Accepting new patients
Wake Forest Health Network, LLC CurrentSince Apr 1, 2019 Accepting new patients
Cornerstone Health Care PA CurrentSince Apr 1, 2019 Accepting new patients
Minuteclinic Diagnostic of North Carolina PC Physician Assistant CurrentSince Dec 14, 2012 Accepting new patients
William D. Hunter, MD PA Current Accepting new patients

Locations

2311 Lewisville Clemmons Rd
Clemmons, NC 27012
Phone (336) 713-0400

2555 Court Dr
Ste 400
Gastonia, NC 28054
Phone (704) 864-5550

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

1814 Westchester Dr
Ste 203
High Point, NC 27262
Phone (336) 702-1355

5826 Samet Dr
Ste 101
High Point, NC 27265
Phone (336) 878-6540

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

13 Medical Park Dr
Lexington, NC 27292
Phone (336) 236-4000

1188 Yadkinville Rd
Mocksville, NC 27028
Phone (336) 716-7435

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: msmith2755368@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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": "1206316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1083885610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 CARNEROS CIR",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659485",
            "telephone_number": "336-577-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-713-4240",
            "fax_number": "336-716-6127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MELISSA",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-24",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01297",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "001001297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.