Individual provider Active NPI

Pamela Hope Vetsch, FNP-C

  • Nurse Practitioner
  • Kernersville, NC
National Provider Identifier
1265890560
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5008331 Issued in NC
Practice address
111 Gateway Center Dr
Kernersville, NC 27284-2999
Phone
(336) 765-3928
Fax
(336) 768-5762
NPI assigned
Feb 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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 5008331 NC
Nurse Practitioner 363L00000X 5008331 NC Primary

Addresses

Primary practice location

111 Gateway Center Dr
Kernersville, NC 27284-2999

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 996-9500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pvetsch48655@direct.novanthealth.org

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
I20160316001800 NC Practitioner - Nurse Practitioner 9537465547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forsyth Emergency Services, P.a.Group PAC ID 1153358171, 24 clinicians

Practice addresses (Care Compare)

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 765-9328

Merit-based Incentive Payment System (MIPS)

Final score
92.52 of 100Reported as group
Quality
83.13
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5008331NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Emergency Services, P.a. CurrentSince Feb 11, 2016 Accepting new patients

Locations

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

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.

NPI Registry JSON

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1265890560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-996-9500",
            "fax_number": "336-996-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 GATEWAY CENTER DR",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842999",
            "telephone_number": "336-765-3928",
            "fax_number": "336-768-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VETSCH",
        "first_name": "PAMELA",
        "middle_name": "HOPE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-02",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5008331",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5008331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pvetsch48655@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "111 Gateway Center Dr",
            "city": "Kernersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272842999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

Verify at the official NPI Registry.