Individual provider Active NPI

Katherine Stokes Pickett, PA-C

  • Physician Assistant
  • Greensboro, NC
National Provider Identifier
1366640807
Registry record updated Aug 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
104029 Issued in NC
Practice address
3511 W Market St
Suite a
Greensboro, NC 27403-4442
Phone
(336) 852-3800
Fax
(336) 852-5725
NPI assigned
Jul 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 104029 NC Primary

Addresses

Primary practice location

3511 W Market St
Suite a
Greensboro, NC 27403-4442

Mailing address

3511 W Market St
Suite a
Greensboro, NC 27403-4442
Phone (336) 852-3800

Other names 1

  • Katherine Stokes Meise Former name

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
I20050201000968 NC Practitioner - Physician Assistant 4183675754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

4610 Country Club Rd
Winston Salem, NC 27104-3520
Phone (336) 716-2255

4614 Country Club Rd
Winston Salem, NC 27104-3520
Phone (336) 716-2255

4618 Country Club Rd
Winston Salem, NC 27104-3520
Phone (336) 716-3926

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Aug 11, 2014 Accepting new patients
Eagle Physicians and Associates PA Past Accepting new patients
Eagle Physicians and Associates PA Past Accepting new patients
Marlette Family Practice, PA Past Accepting new patients

Locations

4614 Country Club Rd
Winston Salem, NC 27104
Phone (336) 716-3787

1200 N Martin Luther King Jr Dr
Winston Salem, NC 27101
Phone (336) 713-9800

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1366640807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 W MARKET ST",
            "address_2": "SUITE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274034442",
            "telephone_number": "336-852-3800",
            "fax_number": "336-852-5725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 W MARKET ST",
            "address_2": "SUITE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274034442",
            "telephone_number": "336-852-3800",
            "fax_number": "336-852-5725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "KATHERINE",
        "middle_name": "STOKES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-06",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "104029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "MEISE",
            "middle_name": "STOKES",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.