Individual provider Active NPI

Scott Joseph Bellamy Nimmons, MD

  • Orthopaedic Surgery Physician
  • Winston Salem, NC
National Provider Identifier
1386090579
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
2022-02379 Issued in NC
Practice address
190 Kimel Park Dr Ste 155
Winston Salem, NC 27103-6946
Phone
(336) 765-6637
Fax
(336) 765-6964
NPI assigned
May 6, 2016
Last updated
Sep 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 2021025289 MO
Orthopaedic Surgery Physician 207X00000X 2022-02379 NC Primary

Addresses

Primary practice location

190 Kimel Park Dr Ste 155
Winston Salem, NC 27103-6946

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

4921 Parkview Pl
Ste 6A/6B/12A
Saint Louis, MO 63110-1032
Phone (314) 747-2551

Other identifiers 1

IdentifierTypeStateIssuer
200099660MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

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
I20220906002649 NC Practitioner - Orthopedic Surgery 8527358845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

190 Kimel Park Dr
Suite 155
Winston Salem, NC 27103-6946
Phone (336) 765-6637

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion100
Laminectomy or laminotomy (partial removal of spine bones)18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022-02379NCMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Sep 1, 2022 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Sep 1, 2022 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

152 E Kinderton Way
Ste 101
Bermuda Run, NC 27006
Phone (336) 893-3180

330 Billingsley Rd
Ste 202
Charlotte, NC 28211
Phone (704) 316-2350

3515 W Market St
Ste 210
Greensboro, NC 27403
Phone (336) 660-5460

1730 Kernersville Medical Pkwy
Ste 204
Kernersville, NC 27284
Phone (336) 277-4460

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

190 Kimel Park Dr
Ste 140
Winston Salem, NC 27103
Phone (336) 277-2225

190 Kimel Park Dr
Ste 155
Winston Salem, NC 27103
Phone (336) 765-6637

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

Interoperability endpoints

  • Direct secure messaging: snimmons1075254@direct.novanthealth.org
  • Direct secure messaging: snimmons270785@direct.sw.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1386090579",
    "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": "190 KIMEL PARK DR STE 155",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036946",
            "telephone_number": "336-765-6637",
            "fax_number": "336-765-6964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4921 Parkview Pl",
            "address_2": "Ste 6A/6B/12A",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101032",
            "country_code": "US",
            "telephone_number": "314-747-2551",
            "fax_number": "314-747-2598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIMMONS",
        "first_name": "SCOTT",
        "middle_name": "JOSEPH BELLAMY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-06",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MO",
            "license": "2021025289",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2022-02379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200099660",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4921 Parkview Pl",
            "address_2": "Ste 6A/6B/12A",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101032",
            "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.