NPIMap

Individual provider Active NPI

Sakeitha L'Tia Crowder, MD

  • Internal Medicine Physician
  • Winston Salem, NC
National Provider Identifier
1356511216
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2009-01520 Issued in NC
Practice address
4937 Old Country Club Rd
Winston Salem, NC 27104-5071
Phone
(336) 718-4510
Fax
(336) 718-4519
NPI assigned
Mar 6, 2008
Last updated
Jun 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2009-01520 NC Primary

Addresses

Primary practice location

4937 Old Country Club Rd
Winston Salem, NC 27104-5071

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

250 Charlois Blvd
Winston Salem, NC 27103-1508
Phone (336) 718-1000

Other identifiers 1

IdentifierTypeStateIssuer
5913899MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address scrowder723590@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091012000374 NC Practitioner - Internal MedicinePractitioner - Geriatric Medicine 8325184955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1400 Westgate Ctr Dr
Suite 130
Winston Salem, NC 27103-3104
Phone (336) 718-7500

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

4937 Old Country Club Rd
Winston Salem, NC 27104-5071
Phone (336) 718-4510

5145 Sellers Rd
Shallotte, NC 28470-3405
Phone (910) 754-4572

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009-01520NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 5, 2020 Accepting new patients
Novant Medical Group, Inc. CurrentSince Jan 5, 2020 Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

1918 Randolph Rd
Ste 220
Charlotte, NC 28207
Phone (704) 316-1125

517 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 384-1406

6915 Village Medical Cir
Clemmons, NC 27012
Phone (336) 718-1680

1750 Kernersville Medical Pkwy
Kernersville, NC 27284
Phone (336) 564-4000

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

114 W 30th St
Ste 800
Winston Salem, NC 27105
Phone (336) 277-2000

1350 Whitaker Ridge Dr
Winston Salem, NC 27106
Phone (336) 718-8000

1351 Westgate Center Dr
Winston Salem, NC 27103
Phone (336) 718-7777

1400 Westgate Center Dr
Ste 130
Winston Salem, NC 27103
Phone (336) 659-8703

2001 Todays Woman Ave
Winston Salem, NC 27105
Phone (336) 722-1818

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

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

4937 Old Country Club Rd
Winston Salem, NC 27104
Phone (336) 546-1666

Interoperability endpoints

  • Direct secure messaging: scrowder723590@direct.novanthealth.org

Organizations & group practices 3

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 10

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": "1204761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1356511216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4937 OLD COUNTRY CLUB RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271045071",
            "telephone_number": "336-718-4510",
            "fax_number": "336-718-4519"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Charlois Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271031508",
            "country_code": "US",
            "telephone_number": "336-718-1000",
            "fax_number": "336-718-1065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROWDER",
        "first_name": "SAKEITHA",
        "middle_name": "L'TIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-06",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2009-01520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5913899",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scrowder723590@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "250 Charlois Blvd",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271031508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.