Individual provider Active NPI

Robin Susanne St.Clair, PA

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1093857765
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-00497 Issued in NC
Practice address
186 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone
(336) 277-2000
Fax
(336) 277-2050
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-00497 NC Primary

Addresses

Primary practice location

186 Kimel Park Dr
Winston Salem, NC 27103-6946

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (704) 384-7606

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address RSTCLAIR16579@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071101000475 NC Practitioner - Physician Assistant 6406838127 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 718-5000

6301 Stadium Dr
Clemmons, NC 27012-8766
Phone (336) 766-6473

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
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Jun 1, 2014 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Jan 1, 2012 Accepting new patients
Forsyth Memorial Hospital Inc CurrentSince Jan 1, 2012 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jun 1, 2014 Accepting new patients
Forsyth Memorial Hospital, Inc Past Accepting new patients

Locations

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

186 Kimel Park Dr
Winston Salem, NC 27103
Phone (336) 277-2000

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

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 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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1093857765",
    "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": "704-384-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 KIMEL PARK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036946",
            "telephone_number": "336-277-2000",
            "fax_number": "336-277-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST.CLAIR",
        "first_name": "ROBIN",
        "middle_name": "SUSANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2023-03-07",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-00497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RSTCLAIR16579@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "186 Kimel Park Dr",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271036946",
            "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.