Individual provider Active NPI

Kandi Byrd Sams, FNP

  • Family Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1114483013
Registry record updated Feb 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F01191561 Issued in NC
Practice address
799 Hickory Tree Rd
Winston Salem, NC 27127-9243
Phone
(336) 716-9253
NPI assigned
Feb 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F01191561 NC Primary

Addresses

Primary practice location

799 Hickory Tree Rd
Winston Salem, NC 27127-9243

Mailing address

Medical Center Blvd
Winston Salem, NC 27157-0001

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
I20190410002863 NC Practitioner - Nurse Practitioner 1456692979 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
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)

799 Hickory Tree Rd
Suite B
Winston Salem, NC 27127-9243
Phone (336) 714-2841

Hospital & facility affiliations

  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047
  • Lexington Memorial Hospital Inc Hospital, Lexington, NC, CCN 340096

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
F01191561NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Theoria Medical CurrentSince Nov 4, 2024 Accepting new patients
Wake Forest University Health Sciences CurrentSince Apr 8, 2019 Accepting new patients
Theoria Medical Past Accepting new patients

Locations

1131 N Church St
Greensboro, NC 27401
Phone (336) 358-5100

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

430 W Health Center Dr
Nags Head, NC 27959
Phone (252) 441-3116

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

799 Hickory Tree Rd
Ste B
Winston Salem, NC 27127
Phone (336) 714-2841

799 Hickory Tree Rd
Winston Salem, NC 27127
Phone (336) 702-1253

Interoperability endpoints

  • Direct secure messaging: ksams2753643@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 3

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": "1550188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1114483013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 HICKORY TREE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271279243",
            "telephone_number": "336-716-9253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMS",
        "first_name": "KANDI",
        "middle_name": "BYRD",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-15",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F01191561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.