Active NPI
Audrey Blaire Whitaker, NP
- Nurse Practitioner
- Winston Salem, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5015001
- Practice address
- Medical Center Blvd
Winston Salem, NC 27157-0001 - Phone
- (336) 716-4081
- Fax
- (336) 716-3065
- NPI assigned
- Sep 8, 2021
- Last updated
- Sep 25, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 50150001 | NC | |
| Nurse Practitioner | 363L00000X | 5015001 | NC | Primary |
Addresses
Primary practice location
Medical Center Blvd
Winston Salem, NC 27157-0001
Mailing address
100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 716-0238
Other practice location 1
250 Hospital Dr
Lexington, NC 27292-6792
Phone (336) 248-5161
Other practice location 2
329 Nc Highway 801 N
Bermuda Run, NC 27006-7905
Phone (336) 713-2121
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50150001 | NC | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wake Forest University Health Sciences | Current | Accepting new patients |
Locations
329 NC Highway 801 N
Bermuda Run, NC 27006
Phone (336) 716-8200
250 Hospital Dr
Lexington, NC 27292
Phone (336) 238-4150
100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947
Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697
Interoperability endpoints
- awhitaker2753479@carolinashealthcaresystem.direct-ci.com
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Winston Salem, NC
- NPI 1003803032
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Winston Salem, NC
- NPI 1063480531
-
- Rehabilitation Hospital Unit
- Winston Salem, NC
- NPI 1114995677
-
dba Wake Forest Baptist Medical Center
- General Acute Care Hospital
- Winston Salem, NC
- NPI 1144211301
-
dba Wake Forest Baptist Medical Center
- Clinical Medical Laboratory
- Winston Salem, NC
- NPI 1609162098
Hospital
-
dba Winston East Pediatrics
- Pediatric Adolescent Medicine Physician
- Winston Salem, NC
- NPI 1912179219
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695600000000",
"number": "1245909837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 KIMEL FOREST DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271036074",
"telephone_number": "336-716-0238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MEDICAL CENTER BLVD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271570001",
"telephone_number": "336-716-4081",
"fax_number": "336-716-3065"
}
],
"practiceLocations": [
{
"address_1": "250 Hospital Dr",
"address_purpose": "LOCATION",
"city": "Lexington",
"state": "NC",
"postal_code": "272926792",
"country_code": "US",
"telephone_number": "336-248-5161",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "329 Nc Highway 801 N",
"address_purpose": "LOCATION",
"city": "Bermuda Run",
"state": "NC",
"postal_code": "270067905",
"country_code": "US",
"telephone_number": "336-713-2121",
"fax_number": "336-716-3065",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHITAKER",
"first_name": "AUDREY",
"middle_name": "BLAIRE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-08",
"last_updated": "2023-09-25",
"certification_date": "2023-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "50150001",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "5015001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.