Jacqueline Heder Mims, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

9800639 Issued in NC

Practice address

2927 Lyndhurst Ave
Winston-Salem, NC 27103-4005

Phone

(336) 765-9350

Fax

(336) 760-4255

NPI assigned

Oct 14, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Jacqueline Marie Heder Former name

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

Obstetrics/Gynecology

Education

University of North Carolina at Chapel Hill School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Uwh of the Carolinas PLLCGroup PAC ID 0042448169, 329 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

Merit-based Incentive Payment System (MIPS)

Final score

88.25 of 100Reported as group

Quality

82.32

Promoting interoperability

100

Improvement activities

40

Cost

78.52

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmims155205@direct.novanthealth.org
• Direct secure messaging: jmims2792542@carolinashealthcaresystem.direct-ci.com

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.

• Uwh of the Carolinas, PLLC

  • Obstetrics & Gynecology Physician
  • Morrisville, NC
  • NPI 1639506470
  Medicare reassignment Care Compare group NPD
• Whap, PA

  • Obstetrics & Gynecology Physician
  • Winston Salem, NC
  • NPI 1649261785
  NPD (past)
• Whap,PA

  • Specialist
  • Winston Salem, NC
  • NPI 1902894967
  NPD (past)

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

• Forsyth Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1447200233
  Care Compare affiliation

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1154310043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2927 LYNDHURST AVE",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271034005",
            "telephone_number": "336-765-9350",
            "fax_number": "336-760-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2927 LYNDHURST AVE",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271034005",
            "telephone_number": "336-765-9350",
            "fax_number": "336-760-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMS",
        "first_name": "JACQUELINE",
        "middle_name": "HEDER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-14",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "9800639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891144Y",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1144Y",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "HEDER",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Mills, PHLEBOTOMIST
• Thomas Scott Mills, HIS
• Virginia H Mills, MAED, LPCS, LCAS
• Lisa Millspaw, MS, CCC-SLP
• Grover Ray Mims III, MD
• James Whitman Mims, MD
• Sierra Camille Mims, MD
• Mind and Body Home Care
• Mind Body Institute of the Piedmont, PLLC
• Mindbridge Behavioral Health PLLC

• Obstetrics & Gynecology Physician in Winston-Salem, NC
• Providers in Winston-Salem, NC by specialty
• Obstetrics & Gynecology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.