NPIMap

Individual provider Active NPI

Holly Marie O'Grady Vanbencoten, P.A.

  • Physician Assistant
  • Asheboro, NC
National Provider Identifier
1104151729
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-02105 Issued in NC
Practice address
327 Rock Crusher Rd
Asheboro, NC 27203-8477
Phone
(336) 636-5546
Fax
(336) 636-5145
NPI assigned
Oct 15, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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 0010-02105 NC Primary
Medical Physician Assistant 363AM0700X NC

Addresses

Primary practice location

327 Rock Crusher Rd
Asheboro, NC 27203-8477

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 716-2255

Other practice location 1

1714 Back Creek Ct
Asheboro, NC 27205
Phone (704) 796-1309

Other names 1

  • Holly Marie O'Grady Vanbencoten Former name

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
I20091202000326 NC Practitioner - Physician Assistant 7810036969 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

601 N Elm St
High Point, NC 27262-4331
Phone (336) 716-2734

711 National Hwy
Suite 100
Thomasville, NC 27360-2668
Phone (336) 475-2000

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

Hospital & facility affiliations

  • Hospice of the Piedmont Inc Hospice, High Point, NC, CCN 341511
  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-02105NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Health Care LLC CurrentSince Dec 15, 2024 Accepting new patients
Wake Forest University Health Sciences CurrentSince Dec 9, 2018 Accepting new patients
High Point Regional Health CurrentSince Feb 10, 2015 Accepting new patients
Wake Forest Health Network, LLC CurrentSince Dec 15, 2024 Accepting new patients
Cornerstone Health Care LLC Past Accepting new patients

Locations

327 Rock Crusher Rd
Asheboro, NC 27203
Phone (336) 636-5546

319 Westwood Ave
Uppr
High Point, NC 27262
Phone (336) 878-6419

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

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

711 National Hwy
Ste 100
Thomasville, NC 27360
Phone (336) 475-2000

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

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Interoperability endpoints

  • Direct secure messaging: hvanbencoten2755322@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 11

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 6

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": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1104151729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-716-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 ROCK CRUSHER RD",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272038477",
            "telephone_number": "336-636-5546",
            "fax_number": "336-636-5145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1714 Back Creek Ct",
            "address_purpose": "LOCATION",
            "city": "Asheboro",
            "state": "NC",
            "postal_code": "27205",
            "country_code": "US",
            "telephone_number": "704-796-1309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANBENCOTEN",
        "first_name": "HOLLY MARIE",
        "middle_name": "O'GRADY",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-15",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-02105",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "O'GRADY VANBENCOTEN",
            "middle_name": "MARIE",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Asheboro, NC

Sources for this page

Verify at the official NPI Registry.