Individual provider Active NPI

Nikki Elizabeth Yourshaw, M.D., MPH

  • Pediatrics Physician
  • Winston Salem, NC
National Provider Identifier
1366741993
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2025-00521 Issued in NC
Practice address
2295 E 14TH St
Winston Salem, NC 27105-6804
Phone
(336) 713-8860
Fax
(336) 713-8862
NPI assigned
Mar 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD451556 PA
Pediatrics Physician 208000000X TL37991 SC
Pediatrics Physician 208000000X 2025-00521 NC Primary

Addresses

Primary practice location

2295 E 14TH St
Winston Salem, NC 27105-6804

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 716-2255

Other practice location 1

171 Ashley Ave
Charleston, SC 29425-8905
Phone (843) 792-1414

Other names 1

  • Nikki Elizabeth Waldstein Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150910001910 SC Practitioner - Pediatric Medicine 7517184856 Reassigns benefits to 1 organization
I20250501002556 NC Practitioner - Pediatric Medicine 7517184856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025-00521NCMDPediatrics Physician
MD451556PAMDPediatrics Physician
TL37991SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Apr 25, 2025 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jul 9, 2015 Accepting new patients
University Medical Associates of the Medical University of South Carol Pediatrics CurrentSince Jul 9, 2015 Accepting new patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
North Carolina Baptist Hospital PastSince Apr 25, 2025 Accepting new patients

Locations

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

2295 E 14th St
Winston Salem, NC 27105
Phone (336) 716-0888

2295 E 14th St
Ste 200
Winston Salem, NC 27105

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

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

Interoperability endpoints

  • Direct secure messaging: nyourshaw2998875@carolinashealthcaresystem.direct-ci.com

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": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1366741993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-716-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 E 14TH ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271056804",
            "telephone_number": "336-713-8860",
            "fax_number": "336-713-8862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "171 Ashley Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294258905",
            "country_code": "US",
            "telephone_number": "843-792-1414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOURSHAW",
        "first_name": "NIKKI",
        "middle_name": "ELIZABETH",
        "credential": "M.D., MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-22",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD451556",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "TL37991",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2025-00521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NIKKI",
            "last_name": "WALDSTEIN",
            "middle_name": "ELIZABETH",
            "credential": "M.D., MPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.