Individual provider Active NPI

Andrew Joseph Stricklin, M.D.

  • Emergency Medicine Physician
  • Winston Salem, NC
National Provider Identifier
1245764596
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2021-00873 Issued in NC
Practice address
Medical Center Boulevard
Winston Salem, NC 27157-0001
Phone
(336) 716-2255
Fax
(336) 716-3202
NPI assigned
Apr 13, 2017
Reactivated
Jun 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 2021-00873 NC Primary

Addresses

Primary practice location

Medical Center Boulevard
Winston Salem, NC 27157-0001

Mailing address

220 Braeburn Drive
Winston Salem, NC 27127
Phone (502) 852-8696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20220825003659 KY Practitioner - Emergency Medicine 2668708355 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.68 of 100Reported as group
Improvement activities
40
Cost
74.85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021-00873NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Green Valley Emergency Physicians, LLC Emergency Medicine CurrentSince Apr 1, 2024 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients

Locations

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

1530 Lone Oak Rd
Paducah, KY 42003
Phone (270) 444-2444

2501 Kentucky Ave
Paducah, KY 42003
Phone (270) 575-2180

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1245764596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 BRAEBURN DRIVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27127",
            "telephone_number": "502-852-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BOULEVARD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2255",
            "fax_number": "336-716-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRICKLIN",
        "first_name": "ANDREW",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-13",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "deactivation_date": "2019-04-04",
        "reactivation_date": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2021-00873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.