Nicholas Theophilos Kipreos, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2016-00121 Issued in NC

Practice address

865 W Lake Dr
Mount Airy, NC 27030-2157

Phone

(336) 719-6100

Fax

(336) 719-2313

NPI assigned

Jul 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Family Practice

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Broad River RehabilitationGroup PAC ID 3375801350, 210 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Liberty Home Care V LLC Home health agency, Stuart, VA, CCN 497475
• Amedisys Home Health Care Home health agency, Roanoke, VA, CCN 497275
• Liberty Home Care V, LLC Home health agency, Mount Airy, NC, CCN 347172
• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014
• Northern Regional Hospital Hospital, Mount Airy, NC, CCN 340003
• Sovah Health Danville Hospital, Danville, VA, CCN 490075

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nkipreos336486@direct.novanthealth.org

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.

• Forsyth Memorial Hospital, Inc.

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1104548874
  Medicare reassignment Care Compare group NPD
• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• Broad River Rehabilitation

  • Occupational Therapist
  • Charlotte, NC
  • NPI 1902317589
  Care Compare group
• Forsyth Memorial Hospital, Inc.

  • Cardiovascular Disease Physician
  • Winston Salem, NC
  • NPI 1932935475
  NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Winston Salem, NC
  • NPI 1457792921
  NPD
• Forsyth Memorial Hospital, Inc

  • Family Medicine Physician
  • Mount Airy, NC
  • NPI 1295783108
  NPD (past)

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

• Eraj Holdings, LLC

  • Home Health Agency
  • Mount Airy, NC
  • NPI 1770717894
  Care Compare affiliation
• Forsyth Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1447200233
  Care Compare affiliation
• Northern Hospital of Surry County

  • General Acute Care Hospital
  • Mount Airy, NC
  • NPI 1366449282
  Care Compare affiliation
• Amedisys Home Health of Virginia Sub 2 LLC

  • Home Health Agency
  • Pulaski, VA
  • NPI 1164470738
  Care Compare affiliation
• Danville Regional Medical Center LLC

  • General Acute Care Hospital
  • Martinsville, VA
  • NPI 1386720183
  Care Compare affiliation
• Danville Regional Medical Center, LLC

  • Rural Acute Care Hospital
  • Danville, VA
  • NPI 1154419737
  Care Compare affiliation
• Eraj Holdings, LLC

  • Home Health Agency
  • Stuart, VA
  • NPI 1124252184
  Care Compare affiliation

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1104825926",
    "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": "276-694-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 W LAKE DR",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270302157",
            "telephone_number": "336-719-6100",
            "fax_number": "336-719-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIPREOS",
        "first_name": "NICHOLAS",
        "middle_name": "THEOPHILOS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101049407",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2016-00121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005614236",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nkipreos336486@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "865 W Lake Dr",
            "city": "Mount Airy",
            "state": "NC",
            "country_code": "US",
            "postal_code": "270302157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kelly C Key, FNP
• Amanda Beth Killion, MSW
• Huyi Jin Kim, M.D.
• Gloria Morris King, P-NP
• Kinlaw PLLC
• Ronnie A Kirkman, C,PED
• Scott Douglas Kirkpatrick, CRNA
• Anthony James Koehler, M.D.
• Kriska Health, PLLC
• Jan Kriska, MD

• Family Medicine Physician in Mount Airy, NC
• Providers in Mount Airy, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.