Individual provider Active NPI

Jason Simpore

  • Student in an Organized Health Care Education/Training Program
  • Winston Salem, NC
National Provider Identifier
1518617885
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
799 Hickory Tree Rd Lowr Level
Ste a
Winston Salem, NC 27127-9243
Phone
(336) 702-1253
NPI assigned
Mar 28, 2022
Last updated
Jan 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2025-03554 NC
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

799 Hickory Tree Rd Lowr Level
Ste a
Winston Salem, NC 27127-9243

Mailing address

799 Hickory Tree Rd Lowr Level
Ste a
Winston Salem, NC 27127-9243
Phone (336) 702-1253

Other practice location 1

1601 Owen Dr
Fayetteville, NC 28304-3425
Phone (910) 678-0100

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
I20260224002107 NC Practitioner - Family Practice 6204214315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

799 Hickory Tree Rd
Winston Salem, NC 27127-9243
Phone (336) 714-2846

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025-03554NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Feb 9, 2026 Accepting new patients

Locations

799 Hickory Tree Rd
Winston Salem, NC 27127
Phone (336) 702-1253

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

799 Hickory Tree Rd
Ste A
Winston Salem, NC 27127
Phone (336) 702-1253

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1518617885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 HICKORY TREE RD LOWR LEVEL",
            "address_2": "STE A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271279243",
            "telephone_number": "336-702-1253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 HICKORY TREE RD LOWR LEVEL",
            "address_2": "STE A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271279243",
            "telephone_number": "336-702-1253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043425",
            "country_code": "US",
            "telephone_number": "910-678-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMPORE",
        "first_name": "JASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2025-03554",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.