NPIMap

Individual provider Active NPI

Scott E Konopka, M.D.

  • Family Medicine Physician
  • Wake Forest, NC
National Provider Identifier
1669409686
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
200300165 Issued in NC
Practice address
3213 Rogers Rd
Wake Forest, NC 27587-3805
Phone
(919) 562-2288
Fax
(919) 562-2225
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 200300165 NC Primary

Addresses

Primary practice location

3213 Rogers Rd
Wake Forest, NC 27587-3805

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (919) 562-2288

Other identifiers 1

IdentifierTypeStateIssuer
8913713MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address skonopka29864@direct.novanthealth.org

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
I20041013000839 NC Practitioner - Family Practice 8820058936 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Brody School of Medicine at East Carolina University, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

10810 Mallard Creek Rd
Charlotte, NC 28262-9786
Phone (704) 510-8000

3213 Rogers Rd
Wake Forest, NC 27587-3805
Phone (919) 562-2288

Hospital & facility affiliations

  • Wakemed Home Health Home health agency, Raleigh, NC, CCN 347179
  • Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069
  • Rex Hospital Hospital, Raleigh, NC, CCN 340114

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Aug 1, 2007 Accepting new patients
Novant Health Medical Group, LLC Family Medicine CurrentSince Aug 1, 2007 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 1, 2023 Accepting new patients
Louisburg Hma Physician Management, LLC Family Medicine Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

3213 Rogers Rd
Wake Forest, NC 27587
Phone (919) 562-2288

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 5

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 4

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1669409686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "919-562-2288",
            "fax_number": "919-562-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3213 ROGERS RD",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873805",
            "telephone_number": "919-562-2288",
            "fax_number": "919-562-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONOPKA",
        "first_name": "SCOTT",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200300165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8913713",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skonopka29864@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "3213 Rogers Rd",
            "city": "Wake Forest",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275873805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

Verify at the official NPI Registry.