Individual provider Active NPI

Kimberly Dawn Zander, MD

  • Obstetrics & Gynecology Physician
  • Clemmons, NC
National Provider Identifier
1477609063
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301093227 Issued in MI
Practice address
2341 Lewisville Clemmons Rd
Clemmons, NC 27012-8905
Phone
(336) 716-4039
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4301093227 MI Primary

Addresses

Primary practice location

2341 Lewisville Clemmons Rd
Clemmons, NC 27012-8905

Mailing address

PO Box 602658
Charlotte, NC 28260-2658
Phone (336) 716-2011

Other identifiers 2

IdentifierTypeStateIssuer
1477609063MedicaidVA
Q0118NMedicaidSC

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
I20120910000054 NC Practitioner - Obstetrics/Gynecology 5395807473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2004
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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Sep 1, 2012 Accepting new patients
North Carolina Baptist Hospital Past Accepting new patients

Locations

2341 Lewisville Clemmons Rd
Clemmons, NC 27012
Phone (336) 713-2121

250 Hospital Dr
Lexington, NC 27292
Phone (336) 238-4150

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

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

Interoperability endpoints

  • Direct secure messaging: kzander2754607@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 2

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1477609063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602658",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602658",
            "telephone_number": "336-716-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2341 LEWISVILLE CLEMMONS RD",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128905",
            "telephone_number": "336-716-4039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANDER",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301093227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477609063",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q0118N",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemmons, NC

Sources for this page

Verify at the official NPI Registry.