NPIMap

Individual provider Active NPI

Kevin David Hiatt, MD

  • Neuroradiology Physician
  • Winston Salem, NC
National Provider Identifier
1548689789
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
2019-00268 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone
(336) 716-2011
NPI assigned
Apr 15, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Neuroradiology Physician 2085N0700X 2019-00268 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-0001

Mailing address

Medical Center Blvd
Winston Salem, NC 27157-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200630001678 NC Practitioner - Diagnostic Radiology 6406164359 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wake Forest University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest Health Network LLCGroup PAC ID 4183538895, 276 clinicians
Wake Forest Baptist Imaging LLCGroup PAC ID 3173681681, 76 clinicians

Practice addresses (Care Compare)

1370 W D St
North Wilkesboro, NC 28659-3506
Phone (336) 651-8760

1814 Westchester Dr
High Point, NC 27262-7369
Phone (336) 702-1355

1900 W Park Dr
Suite B
North Wilkesboro, NC 28659-3563
Phone (336) 903-6840

1914 W Park Dr
North Wilkesboro, NC 28659-3563
Phone (336) 903-7710

1916 W Park Dr
North Wilkesboro, NC 28659-3563
Phone (336) 838-9553

1917 W Park Drivce
N Wilkesboro, NC 28659-3506
Phone (336) 667-3762

250 Hospital Dr
Lexington, NC 27292-6792
Phone (336) 716-2734

265 Executive Park Blvd
Winston Salem, NC 27103-1503
Phone (336) 765-5722

4515 Premier Dr
High Point, NC 27265-8356

601 N Elm St
High Point, NC 27262-4331
Phone (336) 716-2734

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019-00268NCMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest Baptist Imaging, LLC CurrentSince Jun 25, 2020 Accepting new patients
Wake Forest Baptist Imaging LLC CurrentSince Sep 27, 2024 Accepting new patients
Wake Forest University Health Sciences CurrentSince Jun 25, 2020 Accepting new patients
Wake Forest Baptist Imaging, LLC CurrentSince Sep 6, 2020 Accepting new patients
Wake Forest Health Network, LLC CurrentSince Jun 1, 2025 Accepting new patients
Wake Forest Health Network LLC Current Accepting new patients
Wake Forest Health Network LLC CurrentSince Jun 1, 2025 Accepting new patients

Locations

223 W Ward St
Ste B
Asheboro, NC 27203
Phone (336) 702-1731

223 W Ward St
#B
Asheboro, NC 27203

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

1814 Westchester Dr
Ste 100
High Point, NC 27262
Phone (336) 802-2397

861 Old Winston Rd
Ste 105
Kernersville, NC 27284
Phone (336) 765-5722

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

265 Executive Park Blvd
Winston Salem, NC 27103
Phone (336) 765-5722

Interoperability endpoints

  • Direct secure messaging: khiatt349981@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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 9

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": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1548689789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIATT",
        "first_name": "KEVIN",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NC",
            "license": "2019-00268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.