Individual provider Active NPI

Pallavi Mishra, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Winston Salem, NC
National Provider Identifier
1164983680
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
49308 Issued in AL
Practice address
Medical Center BLD
Winston Salem, NC 27157-0001
Phone
(336) 716-4649
Fax
(336) 713-2462
NPI assigned
Mar 27, 2019
Last updated
Jun 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 49308 AL Primary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 2023-02720 NC

Addresses

Primary practice location

Medical Center BLD
Winston Salem, NC 27157-0001

Mailing address

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-4649

Other practice location 1

5003 Old Clinic Building Cb# 7550
Chapel Hill, NC 27599-4220
Phone (919) 445-6764

Other practice location 2

1713 6th Ave S
Birmingham, AL 35294-4220
Phone (205) 934-4107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241024000247 AL Practitioner - Geriatric MedicinePractitioner - Hospice/Palliative Care 0749637973 Reassigns benefits to 1 organization
I20260226003784 NC Practitioner - Geriatric MedicinePractitioner - Internal Medicine 0749637973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Hospice/Palliative Care
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

619 19TH St S
Birmingham, AL 35246-0001
Phone (205) 934-3460

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
49308ALMDGeriatric Medicine (Internal Medicine) Physician
2023-02720NCMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Feb 20, 2026 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Aug 15, 2024 Accepting new patients
University of Alabama at Birmingham Past Accepting new patients

Locations

1713 6th Ave S
Birmingham, AL 35294
Phone (205) 934-4107

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

619 19th St S
Birmingham, AL 35249

601 N Elm St
High Point, NC 27262
Phone (336) 878-6419

Medical Ctr
Winston Salem, NC 27157
Phone (336) 716-2225

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1164983680",
    "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",
            "telephone_number": "336-716-4649",
            "fax_number": "336-713-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-4649",
            "fax_number": "336-713-2462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5003 Old Clinic Building Cb# 7550",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275994220",
            "country_code": "US",
            "telephone_number": "919-445-6764",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1713 6th Ave S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352944220",
            "country_code": "US",
            "telephone_number": "205-934-4107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISHRA",
        "first_name": "PALLAVI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "AL",
            "license": "49308",
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NC",
            "license": "2023-02720",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.