Individual provider Active NPI

Cathy H Shore, MD

  • Adult Medicine Physician
  • Yadkinville, NC
National Provider Identifier
1366437394
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
30042 Issued in NC
Practice address
624 W Main St
Yadkinville, NC 27055-7804
Phone
(336) 679-6758
Fax
(336) 679-6744
NPI assigned
Sep 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 30042 NC Primary

Addresses

Primary practice location

624 W Main St
Yadkinville, NC 27055-7804

Mailing address

3225 Country Club Rd
Yadkinville, NC 27055-5132
Phone (336) 679-7393

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
I20040626000337 NC Practitioner - Hospice/Palliative CarePractitioner - Emergency MedicinePractitioner - Family Practice 9335125764 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice & Palliative Carecenter Adult Medicine CurrentSince Oct 17, 2015 Accepting new patients
Hospice & Palliative Carecenter CurrentSince Oct 17, 2015 Accepting new patients
Emcare Physician Providers, Inc. Past Accepting new patients
United Emergency Services, Inc. Past Accepting new patients

Locations

101 Hospice Ln
Winston Salem, NC 27103
Phone (336) 768-3972

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1366437394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 COUNTRY CLUB RD",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270555132",
            "telephone_number": "336-679-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 W MAIN ST",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270557804",
            "telephone_number": "336-679-6758",
            "fax_number": "336-679-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "CATHY",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NC",
            "license": "30042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yadkinville, NC

Sources for this page

Verify at the official NPI Registry.