NPIMap

Individual provider Active NPI

Patricia Mills Klein, P.A.-C

  • Medical Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1184628745
Registry record updated Jun 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
101115 Issued in NC
Practice address
3333 Brookview Hills Blvd
Ste 207
Winston-Salem, NC 27103-5661
Phone
(336) 765-5250
Fax
(336) 659-0953
NPI assigned
Jun 10, 2005
Last updated
Jun 25, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 101115 NC Primary

Addresses

Primary practice location

3333 Brookview Hills Blvd
Ste 207
Winston-Salem, NC 27103-5661

Mailing address

1701 Westchester Dr
Ste 850
High Point, NC 27262-7254
Phone (336) 802-2400

Other identifiers 2

IdentifierTypeStateIssuer
P00391426OtherNCRR MEDICARE
101115OtherNCMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070509000587 NC Practitioner - Physician Assistant 6608972567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wake Forest University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest Health Network LLCGroup PAC ID 4183538895, 276 clinicians

Practice addresses (Care Compare)

770 Highland Oaks Dr
Winston Salem, NC 27103-7105
Phone (336) 765-5250

905 Phillips Ave
High Point, NC 27262-7075
Phone (336) 802-2040

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
101115NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest Health Network, LLC CurrentSince Feb 1, 2007 Accepting new patients
Cornerstone Health Care, PA CurrentSince Feb 1, 2007 Accepting new patients
Cornerstone Health Care PA Past Accepting new patients
Wake Forest Health Network LLC Past Accepting new patients

Locations

1701 Westchester Dr
Ste 850
High Point, NC 27262
Phone (336) 802-2400

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

861 Old Winston Rd
Ste 101
Kernersville, NC 27284
Phone (336) 904-0043

Organizations & group practices 5

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 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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245888000000",
    "number": "1184628745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WESTCHESTER DR",
            "address_2": "STE 850",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627254",
            "telephone_number": "336-802-2400",
            "fax_number": "336-802-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BROOKVIEW HILLS BLVD",
            "address_2": "STE 207",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271035661",
            "telephone_number": "336-765-5250",
            "fax_number": "336-659-0953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "PATRICIA",
        "middle_name": "MILLS",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-10",
        "last_updated": "2009-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "101115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00391426",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "101115",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.