Individual provider Active NPI

Nicholas Vernon, DO

  • Family Medicine Physician
  • Ronda, NC
National Provider Identifier
1285212985
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2024-00539 Issued in NC
Practice address
3369 Clingman Rd
Ronda, NC 28670-8708
Phone
(336) 984-3003
NPI assigned
Apr 1, 2021
Last updated
Jun 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2024-00539 NC Primary

Addresses

Primary practice location

3369 Clingman Rd
Ronda, NC 28670-8708

Mailing address

3369 Clingman Rd
Ronda, NC 28670-8708
Phone (336) 984-3003

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240801000268 NC Practitioner - Family Practice 6608225651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Liberty Univ College of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5229 Rock Creek Rd
Hays, NC 28635-9267
Phone (336) 696-2711

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024-00539NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hugh Chatham Memorial Hospital, Inc CurrentSince Jul 15, 2024 Accepting new patients
Hugh Chatham Memorial Hospital, Inc. Family Medicine CurrentSince Jul 15, 2024 Accepting new patients
Hugh Chatham Memorial Hospital, Inc Past Accepting new patients
Hugh Chatham Memorial Hospital, Inc Family Medicine Past Accepting new patients
Hugh Chatham Memorial Hospital, Inc. Family Medicine Past Accepting new patients

Locations

911 E Atkins St
#D
Dobson, NC 27017
Phone (336) 374-1010

200 Johnson Ridge Medical Park
Elkin, NC 28621
Phone (336) 526-0040

360 Parkwood Medical Park
Elkin, NC 28621
Phone (336) 527-5960

600 Chatham Medical Park
Elkin, NC 28621
Phone (336) 527-7000

631 CC Camp Rd
Elkin, NC 28621
Phone (336) 366-1072

5229 Rock Creek Rd
Hays, NC 28635
Phone (336) 696-2711

546 Winston Rd
Jonesville, NC 28642
Phone (336) 526-0037

3369 Clingman Rd
Ronda, NC 28670
Phone (336) 984-3003

Interoperability endpoints

  • Direct secure messaging: nvernon@clingmanmedicalcenter.gwaydirect.com

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1285212985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3369 CLINGMAN RD",
            "city": "RONDA",
            "state": "NC",
            "postal_code": "286708708",
            "telephone_number": "336-984-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3369 CLINGMAN RD",
            "city": "RONDA",
            "state": "NC",
            "postal_code": "286708708",
            "telephone_number": "336-984-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNON",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-01",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2024-00539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronda, NC

Sources for this page

Verify at the official NPI Registry.