Individual provider Active NPI

Lynne Baheyeah Daniels, PA-C

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1699890715
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
102895 Issued in NC
Practice address
160 Kimel Forest Dr Ste 250
Winston Salem, NC 27103-6144
Phone
(336) 306-9068
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2026

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 006559 GA
Physician Assistant 363A00000X 1021 SC
Physician Assistant 363A00000X 102895 NC Primary

Addresses

Primary practice location

160 Kimel Forest Dr Ste 250
Winston Salem, NC 27103-6144

Mailing address

160 Kimel Forest Dr Ste 250
Winston Salem, NC 27103-6144

Other identifiers 2

IdentifierTypeStateIssuer
ZA0000024MedicaidNC
003154214AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA, NC3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20050615000376 SC Practitioner - Physician Assistant 6305880857 Reassigns benefits to 1 organization
I20121128000669 GA Practitioner - Physician Assistant 6305880857 Reassigns benefits to 1 organization
I20220112002500 NC Practitioner - Physician Assistant 6305880857 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1021SCMDAthletic Trainer
006559GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Moses Cone Medical Services, Inc. Physician Assistant CurrentSince Dec 6, 2022 Accepting new patients
St Josephs Candler Urgent Care Centers LLC CurrentSince Sep 2, 2020 Accepting new patients
Moses Cone Medical Services, Inc. CurrentSince Dec 6, 2022 Accepting new patients
Optim Orthopedics, LLC Past Accepting new patients
Optim Orthopedics, LLC PastSince Oct 6, 2019 Accepting new patients

Locations

101 Saint Josephs Candler Dr
Ste 100
Pooler, GA 31322
Phone (912) 450-1945

1126 N Church St
Ste 300
Greensboro, NC 27401
Phone (336) 547-1700

940 Golf House Ct E
Whitsett, NC 27377
Phone (336) 449-9848

3 Progressive St
Bluffton, SC 29910
Phone (843) 548-0533

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1699890715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 KIMEL FOREST DR STE 250",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 KIMEL FOREST DR STE 250",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036144",
            "telephone_number": "336-306-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "LYNNE",
        "middle_name": "BAHEYEAH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "006559",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1021",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA0000024",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003154214A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.