Individual provider Active NPI

Katherine Bowman Simerson, FNP

  • Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1740722479
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5009084 Issued in NC
Practice address
3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone
(336) 718-8383
Fax
(336) 718-9622
NPI assigned
Nov 11, 2016
Last updated
Apr 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5009084 NC Primary

Addresses

Primary practice location

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 718-8383

Other practice location 1

501 Hickory Branch Dr
Greensboro, NC 27409-9601
Phone (336) 878-2260

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ksimerson648409@direct.novanthealth.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170220000916 NC Practitioner - Nurse Practitioner 6204119134 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

185 Kimel Park Dr
Suite 201
Winston Salem, NC 27103-6973
Phone (336) 765-6637

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Dec 23, 2018 Accepting new patients
Carolina Medicorp Enterprises, LLC CurrentSince Sep 12, 2020 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Dec 23, 2018 Accepting new patients

Locations

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

501 Hickory Branch Rd
Greensboro, NC 27409
Phone (336) 878-2260

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

185 Kimel Park Dr
Ste 201
Winston Salem, NC 27103
Phone (336) 760-9411

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

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1478822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1740722479",
    "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": "336-718-8383",
            "fax_number": "336-718-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SILAS CREEK PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "telephone_number": "336-718-8383",
            "fax_number": "336-718-9622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Hickory Branch Dr",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274099601",
            "country_code": "US",
            "telephone_number": "336-878-2260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMERSON",
        "first_name": "KATHERINE",
        "middle_name": "BOWMAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-11",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5009084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksimerson648409@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "501 Hickory Branch Dr",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274099601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.