Individual provider Active NPI

Christina Cecilia Stieber, PA-C

  • Physician Assistant
  • Kernersville, NC
National Provider Identifier
1669707295
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-15289 Issued in NC
Practice address
794 S Main St Ste B
Kernersville, NC 27284-4074
Phone
(336) 904-2317
Fax
(336) 443-6030
NPI assigned
Oct 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1086335
Physician Assistant 363A00000X PA9107206 FL
Physician Assistant 363A00000X 0010-15289 NC Primary

Addresses

Primary practice location

794 S Main St Ste B
Kernersville, NC 27284-4074

Mailing address

PO Box 601843
Charlotte, NC 28260-1843
Phone (336) 904-2317

Other practice location 1

38021 Market Sq
Zephyrhills, FL 33542-7504
Phone (813) 715-0374

Other identifiers 2

IdentifierTypeStateIssuer
016363300MedicaidFL
P1595404OtherFLRR MCR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160122001727 FL Practitioner - Physician Assistant 4587882725 Reassigns benefits to 1 organization
I20250924002281 NC Practitioner - Physician Assistant 4587882725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Practice addresses (Care Compare)

794 S Main St
Suite B
Kernersville, NC 27284-4074
Phone (336) 904-2317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9107206FLMDPhysician Assistant
0010-15289NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Medicorp Enterprises, LLC CurrentSince Jul 25, 2025 Accepting new patients
Carolina Medicorp Enterprises Inc Past Accepting new patients

Locations

9550 Rocky River Rd
Ste 150
Charlotte, NC 28215
Phone (704) 457-1510

794 S Main St
Ste B
Kernersville, NC 27284
Phone (336) 904-2317

600 Highland Oaks Dr
Winston Salem, NC 27103
Phone (366) 774-0040

Interoperability endpoints

  • Direct secure messaging: cstieber1724319@direct.novanthealth.org

Organizations & group practices 4

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": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1669707295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601843",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601843",
            "telephone_number": "336-904-2317",
            "fax_number": "336-443-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "794 S MAIN ST STE B",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272844074",
            "telephone_number": "336-904-2317",
            "fax_number": "336-443-6030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "38021 Market Sq",
            "address_purpose": "LOCATION",
            "city": "Zephyrhills",
            "state": "FL",
            "postal_code": "335427504",
            "country_code": "US",
            "telephone_number": "813-715-0374",
            "fax_number": "813-355-5090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STIEBER",
        "first_name": "CHRISTINA",
        "middle_name": "CECILIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-15",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "1086335",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107206",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-15289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016363300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P1595404",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

Verify at the official NPI Registry.