Individual provider Active NPI

Jennifer Santos, FNP-C

  • Family Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1285387639
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5015679 Issued in NC
Practice address
4605 Country Club Rd
Winston Salem, NC 27104-3519
Phone
(336) 768-3632
NPI assigned
Jan 26, 2022
Last updated
Jan 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5015679 NC Primary

Addresses

Primary practice location

4605 Country Club Rd
Winston Salem, NC 27104-3519

Mailing address

3766 Burbank LN
Winston Salem, NC 27106-5079
Phone (336) 624-6635

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
I20220314000643 NC Practitioner - Nurse Practitioner 3072908854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uwh of the Carolinas PLLCGroup PAC ID 0042448169, 329 clinicians

Practice addresses (Care Compare)

4605 Country Club Rd
Winston Salem, NC 27104-3519
Phone (336) 768-3632

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.25 of 100Reported as group
Quality
82.32
Promoting interoperability
100
Improvement activities
40
Cost
78.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5015679NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Uwh of the Carolinas, PLLC CurrentSince Jan 3, 2022 Accepting new patients
Whap, PA Past Accepting new patients

Locations

1806 S Hawthorne Rd
Winston Salem, NC 27103
Phone (336) 768-3632

4605 Country Club Rd
Winston Salem, NC 27104
Phone (336) 310-5038

Interoperability endpoints

  • Direct secure messaging: jennifer.santos.1@7773.direct.athenahealth.com

Organizations & group practices 2

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 1

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": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1285387639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3766 BURBANK LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271065079",
            "telephone_number": "336-624-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 COUNTRY CLUB RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271043519",
            "telephone_number": "336-768-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "JENNIFER",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5015679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.