Lori Goco Kellam, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

9600966 Issued in NC

Practice address

2825 Lyndhurst Ave Ste 101
Winston Salem, NC 27103-4146

Phone

(336) 277-6300

Fax

(336) 277-6309

NPI assigned

Jul 26, 2006

Last updated

Oct 19, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Lori Ann-Goco Kellam Other name

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

Wake Forest University School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Novant Health Thomasville Medical Center LLCGroup PAC ID 5890605224, 101 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Medical Park Hospital Hospital, Winston-Salem, NC, CCN 340148
• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014
• Novant Health Thomasville Medical Center Hospital, Thomasville, NC, CCN 340085

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group NPD
• Novant Health Thomasville Medical Center, LLC

  dba Professional Service of Thomasville Medical Center

  • Specialist
  • Thomasville, NC
  • NPI 1033160205
  Medicare reassignment Care Compare group NPD
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Palliative Care

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Matthews, NC
  • NPI 1760812184
  NPD
• Novant Health Thomasville Medical Center LLC

  dba Novant Health Cancer Institute

  • Hematology & Oncology Physician
  • Winston Salem, NC
  • NPI 1649159609
  NPD
• Novant Health Thomasville Medical Center, LLC

  dba NH Thomasville Cancer Clinics

  • Hematology & Oncology Physician
  • Winston Salem, NC
  • NPI 1083338677
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Northlake Dermatology

  • Dermatopathology Physician
  • Huntersville, NC
  • NPI 1396751640
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Forsyth Memorial Hospital, Inc.

  dba Novant Health Forsyth Medical Center

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1447200233
  Care Compare affiliation
• Medical Park Hospital LLC

  dba Novant Health Medical Park Hospital

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1538111828
  Care Compare affiliation
• Novant Health Thomasville Medical Center, LLC

  dba Novant Health Thomasville Medical Center

  • General Acute Care Hospital
  • Thomasville, NC
  • NPI 1801848767
  Care Compare affiliation

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1750305595",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 LYNDHURST AVE STE 101",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034146",
            "telephone_number": "336-277-6300",
            "fax_number": "336-277-6309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 S Hawthorne Rd",
            "address_2": "SUITE 480",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271033913",
            "country_code": "US",
            "telephone_number": "336-765-0155",
            "fax_number": "336-765-5494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLAM",
        "first_name": "LORI",
        "middle_name": "GOCO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "9600966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "48204",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8948204",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lkellam95561@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1900 S Hawthorne Rd",
            "address_2": "SUITE 480",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271033913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "KELLAM",
            "middle_name": "ANN-GOCO",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Marguerite Bridget Keil, MSW, LCSWA
• Brian Andrew Keith
• Philip David Keith, MD
• Anita A. Kelkar, M.D/M.P.H.
• Leslie Kellam, DNP
• Molly Kellam, FNP-C
• Thomas Clark Kellam
• Amber Brewer Keller, PA-C
• Calvin Woodrow Keller, LAT-ATC
• Jennifer Keller, FNP

• Surgery Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.