Organization Active NPI

Covenant Spine and Neurology, PLLC

  • Neurological Surgery Physician
  • Kernersville, NC
National Provider Identifier
1265150494
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
COVENANT SPINE AND NEUROLOGY, PLLC
Practice address
280 Broad St Ste a
Kernersville, NC 27284-2948
Phone
(336) 716-4020
Fax
(336) 761-4051
NPI assigned
Aug 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Authorized official

Name
Sherry Beers
Title
Practice Administrator
Phone
(336) 761-4020

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X Primary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X
Durable Medical Equipment & Medical Supplies 332B00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X

Addresses

Primary practice location

280 Broad St Ste a
Kernersville, NC 27284-2948

Mailing address

280 Broad St Ste a
Kernersville, NC 27284-2948
Phone (336) 761-4020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20221214002261 NC Part B Supplier - Clinic/Group Practice 5395114300 Receives reassigned benefits from 6 practitioners
Practice locations: Kernersville, NC; King, NC; Raleigh, NC; Winston Salem, NC
O20230914003546 NC DME Supplier - Multi-Specialty - Physician 5395114300 Practice locations: Winston Salem, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2283169Covenant Spine and Neurology, PLLC280 Broad St. Ste a, Kernersville, NC 27284Certificate of waiverJun 1, 2027

National Provider Directory

National Provider Directory

Locations

280 Broad St
Ste A
Kernersville, NC 27284
Phone (336) 277-6430

219 Moore Rd
King, NC 27021
Phone (336) 760-3007

3333 Brookview Hills Blvd
Ste 102
Winston Salem, NC 27103
Phone (336) 760-1448

3333 Brookview Hills Blvd
#10
Winston Salem, NC 27103

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742860800000",
    "number": "1265150494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 BROAD ST STE A",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842948",
            "telephone_number": "336-761-4020",
            "fax_number": "336-761-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 BROAD ST STE A",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842948",
            "telephone_number": "336-716-4020",
            "fax_number": "336-761-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT SPINE AND NEUROLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-15",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A",
        "authorized_official_last_name": "BEERS",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "336-761-4020"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.