Jips John Zachariah, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

201701310 Issued in NC

Practice address

633 Brookdale Dr Ste 100
Statesville, NC 28677-3471

Phone

(704) 873-7850

Fax

(704) 838-1544

NPI assigned

Jan 18, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

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

Specialty

Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Healthcare PAGroup PAC ID 9638070683, 226 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Iredell Memorial Hospital Inc Hospital, Statesville, NC, CCN 340039
• North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jipszachariah@phc.allscriptsdirect.net

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.

• Piedmont Healthcare, P.a.

  • Internal Medicine Physician
  • Statesville, NC
  • NPI 1912999897
  Medicare reassignment Care Compare group NPD
• Piedmont Healthcare, PA

  • Durable Medical Equipment & Medical Supplies
  • Statesville, NC
  • NPI 1639041320
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Iredell Memorial Hospital, Incorporated

  • General Acute Care Hospital
  • Statesville, NC
  • NPI 1417944224
  Care Compare affiliation
• North Carolina Baptist Hospital

  • Psychiatric Hospital Unit
  • Winston Salem, NC
  • NPI 1063480531
  Care Compare affiliation
• North Carolina Baptist Hospital

  • Rehabilitation Hospital Unit
  • Winston Salem, NC
  • NPI 1114995677
  Care Compare affiliation
• North Carolina Baptist Hospital

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1144211301
  Care Compare affiliation
• North Carolina Baptist Hospital

  • Clinical Medical Laboratory
  • Winston Salem, NC
  • NPI 1609162098

  Hospital

  Care Compare affiliation
• North Carolina Baptist Hospital

  • Pediatric Adolescent Medicine Physician
  • Winston Salem, NC
  • NPI 1912179219

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1508137977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 BROOKDALE DR STE 100",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773471",
            "telephone_number": "704-873-7850",
            "fax_number": "704-838-1544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHARIAH",
        "first_name": "JIPS",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-18",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101252435",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "266398",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "266398",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "2017-01310",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NC",
            "license": "201701310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Interventional Cardiology Physician in Statesville, NC
• Providers in Statesville, NC by specialty
• Interventional Cardiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.