Individual provider Active NPI

Christina Un Cepeda-Chyr, PA-C

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1447829619
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-11348 Issued in NC
Practice address
114 Charlois Blvd
Winston Salem, NC 27103-1522
Phone
(336) 765-5470
Fax
(336) 499-5428
NPI assigned
Jun 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-11348 NC Primary

Addresses

Primary practice location

114 Charlois Blvd
Winston Salem, NC 27103-1522

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

500 Shepherd St
Winston Salem, NC 27103-1633
Phone (336) 716-4039

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211012002514 NC Practitioner - Physician Assistant 5597163162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wake Forest University School of Medicine, 2021
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)

114 Charlois Blvd
Winston Salem, NC 27103-1522
Phone (336) 765-5470

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-11348NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Medical Group, Inc. CurrentSince Feb 4, 2024 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 4, 2024 Accepting new patients
North Carolina Baptist Hospital PastSince Oct 1, 2021 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

4130 Clemmons Rd
Clemmons, NC 27012
Phone (336) 277-1890

114 Charlois Blvd
Winston Salem, NC 27103

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

Interoperability endpoints

  • Direct secure messaging: ccepedachyr1304903@direct.novanthealth.org

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": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1447829619",
    "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": "114 CHARLOIS BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031522",
            "telephone_number": "336-765-5470",
            "fax_number": "336-499-5428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Shepherd St",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271031633",
            "country_code": "US",
            "telephone_number": "336-716-4039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CEPEDA-CHYR",
        "first_name": "CHRISTINA",
        "middle_name": "UN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.