Joan Priddy-Southern, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

83415 Issued in NC

Practice address

145 Kimel Park Dr
Suite 330
Winston Salem, NC 27103-6984

Phone

(336) 765-6181

Fax

(336) 714-6481

NPI assigned

Mar 4, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolinas Pain Institute, PAGroup PAC ID 0244218550, 6 clinicians

Newhope Medical Group PAGroup PAC ID 3173965845, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Carolinas Pain Institute, PA

  • Pain Medicine Physician
  • Winston Salem, NC
  • NPI 1376598268
  Medicare reassignment Care Compare group NPD
• Newhope Medical Group PA

  • Family Medicine Physician
  • Kernersville, NC
  • NPI 1306539838
  Medicare reassignment Care Compare group
• Carolinas Pain Institute, PA

  • Pain Medicine Physician
  • Charlotte, NC
  • NPI 1700406253
  NPD
• Carolinas Pain Institute, PA

  • Pain Medicine Physician
  • Charlotte, NC
  • NPI 1790305241
  NPD
• Carolinas Pain Institute, PA

  • Interventional Pain Medicine Physician
  • Asheboro, NC
  • NPI 1942547120
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1299196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1427356153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 KIMEL PARK DR",
            "address_2": "SUITE 330",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036984",
            "telephone_number": "336-765-6181",
            "fax_number": "336-714-6481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 KIMEL PARK DR",
            "address_2": "SUITE 330",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036984",
            "telephone_number": "336-765-6181",
            "fax_number": "336-714-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIDDY-SOUTHERN",
        "first_name": "JOAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-04",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "83415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004906",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsouthern98253@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "145 Kimel Park Dr",
            "address_2": "Suite 330",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271036984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert David Price, DMD
• Sarah Danielle Price
• Sarah Newmeyer Price, PHD
• Zula M Price, FNP-BC
• Michael Ann Priddy-Arrington, MD
• Kristopher Neal Priddy, PA-C
• David Harding Priest, M.D.
• Brianna Marie Prim-Reed, LCSW
• Will Stewart Primasing
• Prime Care One LLC

• Adult Health Nurse Practitioner in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Adult Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.