NPIMap

Individual provider Active NPI

Jennifer Lynn Gabbard, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Winston Salem, NC
National Provider Identifier
1730319583
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
2015-01623 Issued in NC
Practice address
1 Medical Center Blvd 8TH Floor Janeway Tower
Winston Salem, NC 27157-0001
Phone
(363) 713-8250
Fax
(339) 713-8252
NPI assigned
Jul 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 208776 NC
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 208776 NC
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 208776 NC
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 2015-01623 NC Primary

Addresses

Primary practice location

1 Medical Center Blvd 8TH Floor Janeway Tower
Winston Salem, NC 27157-0001

Mailing address

1 Medical Center Blvd 8TH Floor Janeway Tower
Winston Salem, NC 27157-0001
Phone (363) 713-8250

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
I20150928000409 NC Practitioner - Geriatric Medicine 9234372855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • Amedisys Home Health of Winston Salem Home health agency, Winston-Salem, NC, CCN 347212
  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
208776NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Aug 3, 2015 Accepting new patients
Hospitalists of Arizona, Inc Internal Medicine Past Accepting new patients

Locations

4614 Country Club Rd
Winston Salem, NC 27104
Phone (336) 716-3787

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

Interoperability endpoints

  • Direct secure messaging: jgabbard2754316@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 2

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 6

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": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1730319583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD 8TH FLOOR JANEWAY TOWER",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "363-713-8250",
            "fax_number": "336-713-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD 8TH FLOOR JANEWAY TOWER",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "363-713-8250",
            "fax_number": "339-713-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABBARD",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "208776",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NC",
            "license": "208776",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NC",
            "license": "208776",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NC",
            "license": "2015-01623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.