Individual provider Active NPI

Holly Crain Hanes, M.D.

  • Pediatrics Physician
  • Winston Salem, NC
National Provider Identifier
1609058338
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2009-00822 Issued in NC
Practice address
1400 Westgate Center Dr Ste 206
Winston Salem, NC 27103-3104
Phone
(336) 815-4890
NPI assigned
Dec 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2009-00822 NC Primary

Addresses

Primary practice location

1400 Westgate Center Dr Ste 206
Winston Salem, NC 27103-3104

Mailing address

1400 Westgate Center Dr Ste 206
Winston Salem, NC 27103-3104
Phone (336) 815-4890

Other identifiers 1

IdentifierTypeStateIssuer
5912127MedicaidNC

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
I20090917000238 NC Practitioner - Pediatric MedicinePractitioner - Pulmonary Disease 9436205309

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009-00822NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Children'S Clinic of Winston-Salem Pediatrics PastSince Mar 19, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: hhanes2754381@carolinashealthcaresystem.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1609058338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 WESTGATE CENTER DR STE 206",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033104",
            "telephone_number": "336-815-4890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 WESTGATE CENTER DR STE 206",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033104",
            "telephone_number": "336-815-4890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANES",
        "first_name": "HOLLY",
        "middle_name": "CRAIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-05",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2009-00822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5912127",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.