Kelli Nichols Case, FNP-C
Individual provider Active NPI Nurse Practitioner · Mocksville, NC
NPI 1124290283 · NPPES record last updated Dec 29, 2021
Key facts
- NPI
- 1124290283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 5003887 (NC)
- Practice address
- 485 Valley Rd
Mocksville, NC 27028-2074 - Phone
- (336) 751-8000
- Fax
- (336) 751-8010
- NPI assigned
- Mar 29, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Forsyth Memorial Hospital Inc
Practice addresses (Care Compare)
3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 277-8800
485 Valley Rd
Mocksville, NC 27028-2074
Phone (336) 751-8000
Hospital & facility affiliations
- Novant Health Forsyth Medical Center
- Novant Health Rowan Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080807000300 | NC | Practitioner - Nurse Practitioner | 0244304319 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wake Forest Health Network LLC | Current |
Accepting new patients | |
| Forsyth Memorial Hospital Inc | Current |
Accepting new patients | |
| Wake Forest Health Network LLC | Current | Accepting new patients | |
| Forsyth Memorial Hospital, Inc. | Current |
Accepting new patients | |
| Novant Health Medical Group, LLC | Current |
Accepting new patients | |
| Forsyth Memorial Hospital Inc | Current |
Accepting new patients | |
| Forsyth Memorial Hospital, Inc. | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Wake Forest Health Network, LLC | Current |
Accepting new patients | |
| Novant Health Medical Group, LLC | Current |
Accepting new patients | |
| Forsyth Memorial Hospital, Inc | Past | Accepting new patients |
Locations
152 E Kinderton Way
Ste 101
Bermuda Run, NC 27006
Phone (336) 893-3180
1918 Randolph Rd
Ste 400
Charlotte, NC 28207
Phone (704) 384-9437
10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000
125 Queens Rd
Charlotte, NC 28204
Phone (980) 302-6380
6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473
2290 Remount Rd
Gastonia, NC 28054
Phone (704) 316-4979
905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040
1300 N University Pkwy
High Point, NC 27262
Phone (336) 841-4683
291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181
485 Valley Rd
Mocksville, NC 27028
Phone (336) 751-8000
648 Almondridge Dr
Rural Hall, NC 27045
Phone (336) 969-0510
5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441
100 Robinhood Medical Plz
Winston Salem, NC 27106
Phone (336) 718-0560
2025 Frontis Plaza Blvd
Ste 120
Winston Salem, NC 27103
Phone (336) 277-2200
190 Kimel Park Dr
Ste 120
Winston Salem, NC 27103
Phone (336) 277-2200
175 Kimel Park Dr
Ste 100
Winston Salem, NC 27103
Phone (336) 277-1811
3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800
175 Kimel Park Dr
Winston Salem, NC 27103
Phone (336) 718-1006
245 Charlois Blvd
#C
Winston Salem, NC 27103
Phone (336) 718-6280
2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300
100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947
Interoperability endpoints
- kcarpenter146010@direct.novanthealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5003887 | NC | Yes |
Addresses
Primary practice location
485 Valley Rd
Mocksville, NC 27028-2074
Mailing address
PO Box 751803
Charlotte, NC 28275-1803
Other practice location 1
2025 Frontis Plaza Blvd
Suite 120
Winston Salem, NC 27103-5663
Phone (336) 277-2200
Other practice location 2
2025 Frontis Plaza Blvd
Suite 120
Winston Salem, NC 27103-5663
Phone (336) 277-2200
Other practice location 3
152 E Kinderton Way Ste 101
Bermuda Run, NC 27006
Phone (336) 893-3180
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7000723 | Medicaid | NC |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kcarpenter146010@direct.novanthealth.org |
Other providers in Mocksville, NC
- Carenet, Inc
- Carnaggio and Piper DMD Ms PA
- Carolina Health & Day Services
- Carolina Neurology East
- Teresa Kay Carter
- Cedar Rock Assisted Living, LLC
- Cedar Rock of Mocksville, LLC
- Melissa Renee Champe - Seagle
- Chelsea Grace Strange Chapman
- David A Chester
All providers in Mocksville, NC · Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.