Individual provider Active NPI

Demetria Ileana Strauch Jacks, MD

  • Medical Oncology Physician
  • Winston Salem, NC
National Provider Identifier
1366670606
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
2015-01669 Issued in NC
Practice address
3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone
(336) 277-8800
NPI assigned
Jun 25, 2009
Last updated
Jul 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LL31902 SC
Hematology & Oncology Physician 207RH0003X ME112135 FL
Hematology & Oncology Physician 207RH0003X 2015-01669 NC
Medical Oncology Physician 207RX0202X 2015-01669 NC Primary

Addresses

Primary practice location

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013

Mailing address

PO Box 75216
Charlotte, NC 28275-0216
Phone (336) 277-8800

Other identifiers 1

IdentifierTypeStateIssuer
007226100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address djacks280337@direct.novanthealth.org

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
I20160129002446 NC Practitioner - Hematology/OncologyPractitioner - HematologyPractitioner - Medical Oncology 3678739257 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Hematology, Medical Oncology
Education
University of South Carolina School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1010 Bethesda CT
Winston Salem, NC 27103-3019
Phone (336) 277-8906

203 Old Lexington Rd
Suite 106
Thomasville, NC 27360-3428
Phone (336) 474-8921

207 Old Lexington Rd
Thomasville, NC 27360-3428
Phone (336) 472-2000

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 277-8800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL31902SCMDInternal Medicine Physician
ME112135FLMDHematology & Oncology Physician
2015-01669NCMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Thomasville Medical Center, LLC Current Accepting new patients
Novant Health Rowan Medical Center, LLC Hematology & Oncology CurrentSince Mar 1, 2022 Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Novant Health Medical Group, LLC Hematology & Oncology CurrentSince Jan 1, 2016 Accepting new patients
Forsyth Memorial Hospital Inc Hematology & Oncology CurrentSince Nov 1, 2015 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 1, 2016 Accepting new patients
Novant Health Rowan Medical Center, LLC Hematology & Oncology CurrentSince Mar 1, 2022 Accepting new patients
Novant Health Rowan Medical Center LLC Current Accepting new patients
Novant Health Thomasville Medical Center LLC Hematology & Oncology CurrentSince Mar 1, 2022 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Nov 1, 2015 Accepting new patients
Novant Health Thomasville Medical Center, LLC Hematology & Oncology CurrentSince Mar 1, 2022 Accepting new patients

Locations

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

1710 Kernersville Medical Pkwy
Ste 116
Kernersville, NC 27284
Phone (336) 564-4170

1919 W Park Dr
North Wilkesboro, NC 28659
Phone (336) 651-2980

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

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

276 Old Mocksville Rd
Ste 800
Statesville, NC 28625
Phone (704) 873-5150

1213 Lexington Ave
#B
Thomasville, NC 27360
Phone (336) 249-6632

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

1010 Bethesda Ct
Winston Salem, NC 27103
Phone (336) 277-6000

175 Kimel Park Dr
Winston Salem, NC 27103
Phone (336) 718-1006

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

Interoperability endpoints

  • Direct secure messaging: djacks280337@direct.novanthealth.org

Organizations & group practices 12

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 2

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": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1366670606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 75216",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282750216",
            "telephone_number": "336-277-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SILAS CREEK PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "telephone_number": "336-277-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKS",
        "first_name": "DEMETRIA",
        "middle_name": "ILEANA STRAUCH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL31902",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME112135",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "2015-01669",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NC",
            "license": "2015-01669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007226100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "djacks280337@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "3333 Silas Creek Pkwy",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271033013",
            "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.