Devora Renee Neely, MSW, P-LCSW

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5018075 Issued in NC

Practice address

175 Kimel Park Dr Ste 100
Winston Salem, NC 27103-6951

Phone

(336) 718-3550

Fax

(336) 277-1825

NPI assigned

May 8, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Novant Health Medical Group Coastal Region LLCGroup PAC ID 2860809936, 577 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dneely791034@direct.novanthealth.org

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.

• Forsyth Memorial Hospital, Inc.

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1104548874
  Medicare reassignment Care Compare group NPD
• Novant Health Medical Group Coastal Region, LLC

  • Cardiovascular Disease Physician
  • Wilmington, NC
  • NPI 1649865791
  Medicare reassignment Care Compare group NPD
• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• Forsyth Memorial Hospital Inc

  • Psychiatry Physician
  • Winston Salem, NC
  • NPI 1508350349
  NPD
• Forsyth Memorial Hospital, Inc.

  • Cardiovascular Disease Physician
  • Winston Salem, NC
  • NPI 1932935475
  NPD
• NMG Health Services LLC

  • Maternal & Fetal Medicine Physician
  • Bolivia, NC
  • NPI 1558242495
  NPD
• Novant Health Medical Group Coastal Region, LLC

  • Psychiatry Physician
  • Wilmington, NC
  • NPI 1881289932
  NPD
• Novant Health Medical Group, LLC

  • Psychiatry Physician
  • Thomasville, NC
  • NPI 1114387370
  NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD

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

• Forsyth Memorial Hospital, Inc.

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

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1750557872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 KIMEL PARK DR STE 100",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036951",
            "telephone_number": "336-718-3550",
            "fax_number": "336-277-1825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "128 N Merritt Ave",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281442636",
            "country_code": "US",
            "telephone_number": "704-296-4640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEELY",
        "first_name": "DEVORA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "MSW, P-LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-08",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P004420",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5018075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathlin Lorraine Neamo, LCSW
• Jake Carlisle Nearine
• Monica Marie Nedeff, RDN, LD
• Daniel Jacob Needham
• Callie Ann Neelands, RD, LD, CSP
• Lauren Joyce Neff, FNP
• Melissa Rosales Neff
• Neighborhood Empowering Wealth
• Neighborhood Empowering Wealth
• Granada Stephens Neil, MD

• Nurse Practitioner in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.