Individual provider Active NPI

Shannon Rebekah James, NP

  • Family Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1144903709
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5018972 Issued in NC
Practice address
1920 W 1St St
Winston Salem, NC 27104-4220
Phone
(336) 716-4479
NPI assigned
Aug 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 313043 NC
Family Nurse Practitioner 363LF0000X 5018972 NC Primary

Addresses

Primary practice location

1920 W 1St St
Winston Salem, NC 27104-4220

Mailing address

1920 W 1St St
Winston Salem, NC 27104-4220
Phone (336) 716-4479

Other practice location 1

1533 S Main St
Winston Salem, NC 27127-2738
Phone (336) 631-1582

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
I20231208001491 NC Practitioner - Nurse Practitioner 9638528193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
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)

1930 N Peace Haven Rd
Winston Salem, NC 27106-4817
Phone (336) 760-5400

Hospital & facility affiliations

  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
313043NCMDRegistered Nurse
5018972NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Oct 31, 2023 Accepting new patients

Locations

1920 W 1st St
Winston Salem, NC 27104
Phone (336) 716-4479

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

1930 N Peace Haven Rd
Winston Salem, NC 27106
Phone (336) 760-5400

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

Interoperability endpoints

  • Direct secure messaging: sjames2791859@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 1

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 5

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": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1144903709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 W 1ST ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271044220",
            "telephone_number": "336-716-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 W 1ST ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271044220",
            "telephone_number": "336-716-4479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1533 S Main St",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271272738",
            "country_code": "US",
            "telephone_number": "336-631-1582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMES",
        "first_name": "SHANNON",
        "middle_name": "REBEKAH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-10",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "313043",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5018972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.