Individual provider Active NPI

Jacquelyn Alyse Vogel, DNP, FNP-BC

  • Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1225706237
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5015036 Issued in NC
Practice address
114 W 30TH St Ste 800
Winston Salem, NC 27105-4269
Phone
(336) 277-2680
Fax
(336) 277-2689
NPI assigned
Sep 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5015036 NC
Nurse Practitioner 363L00000X 5015036 NC Primary

Addresses

Primary practice location

114 W 30TH St Ste 800
Winston Salem, NC 27105-4269

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

2994 Kildaire Farm Rd
Cary, NC 27518-9614
Phone (401) 765-1500

Other practice location 2

16623 Birkdale Commons Pkwy Ste 110
Huntersville, NC 28078-5622
Phone (704) 820-4197

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
I20211118001694 NC Practitioner - Nurse Practitioner 7315336005 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

10810 Mallard Creek Rd
Charlotte, NC 28262-9786
Phone (704) 510-8000

10816 Black Dog LN
Suite 160
Charlotte, NC 28214-1479
Phone (704) 316-3970

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5015036NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Apr 20, 2024 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 20, 2024 Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

10816 Black Dog Ln
Ste 160
Charlotte, NC 28214
Phone (704) 316-3970

114 W 30th St
Ste 800
Winston Salem, NC 27105
Phone (336) 277-2000

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

2001 Todays Woman Ave
Winston Salem, NC 27105
Phone (336) 722-1818

652 E Monmouth St
Winston Salem, NC 27107
Phone (336) 718-4390

Interoperability endpoints

  • Direct secure messaging: jsmith677249@direct.novanthealth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1225706237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 W 30TH ST STE 800",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271054269",
            "telephone_number": "336-277-2680",
            "fax_number": "336-277-2689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2994 Kildaire Farm Rd",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275189614",
            "country_code": "US",
            "telephone_number": "401-765-1500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16623 Birkdale Commons Pkwy Ste 110",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280785622",
            "country_code": "US",
            "telephone_number": "704-820-4197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VOGEL",
        "first_name": "JACQUELYN",
        "middle_name": "ALYSE",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-03",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5015036",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5015036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.