NPIMap

Individual provider Active NPI

Madison McKenzie Bakken, FNP-C

  • Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1386315158
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5015099 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-5450
Phone
(336) 713-8250
Fax
(336) 713-8252
NPI assigned
Sep 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X BAKK-N6SJJ NC
Family Nurse Practitioner 363LF0000X RN2381719 MA
Nurse Practitioner 363L00000X 5015099 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-5450

Mailing address

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 713-8250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211027000955 NC Practitioner - Nurse Practitioner 1557759396 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5015099NCMDNurse Practitioner
BAKK-N6SJJNCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Watauga Medical Center Inc CurrentSince Oct 11, 2021 Accepting new patients
Charles a Cannon Jr Memorial Hospital Inc CurrentSince Oct 11, 2021 Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc. CurrentSince Oct 11, 2021 Accepting new patients
Watauga Medical Center, Inc. Current Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc Current Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc. Current Accepting new patients
Watauga Medical Center Inc CurrentSince Oct 11, 2021 Accepting new patients
Watauga Medical Center Inc CurrentSince Oct 11, 2021 Accepting new patients
Wake Forest University Health Sciences CurrentSince Aug 12, 2024 Accepting new patients
Wake Forest Emergency Providers CurrentSince Aug 8, 2022 Accepting new patients

Locations

336 Deerfield Rd
Boone, NC 28607
Phone (828) 263-1211

155 Furman Rd
Ste 101
Boone, NC 28607
Phone (828) 262-4111

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

601 N Elm St
High Point, NC 27262
Phone (336) 878-6419

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

Interoperability endpoints

  • Direct secure messaging: mbakken2926991@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 10

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": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1386315158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-713-8250",
            "fax_number": "336-713-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271575450",
            "telephone_number": "336-713-8250",
            "fax_number": "336-713-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKKEN",
        "first_name": "MADISON",
        "middle_name": "MCKENZIE",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-22",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "BAKK-N6SJJ",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2381719",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5015099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.