Nicole Marie Lawing Koutlas, MD

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

2021-01464 Issued in NC

Practice address

1372 Westgate Center Dr
Winston Salem, NC 27103-2932

Phone

(336) 659-4814

NPI assigned

Apr 4, 2018

Last updated

Oct 31, 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 3

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

Allergy/Immunology

Education

North Carolina Medical School, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allergy Partners PLLCGroup PAC ID 7113822420, 144 clinicians

Practice addresses (Care Compare)

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.

• Allergy Partners, PLLC

  dba Allergy Partners of Western North Carolina

  • Allergy & Immunology Physician
  • Asheville, NC
  • NPI 1205826559
  Medicare reassignment Care Compare group NPD
• Allergy Partners, PLLC

  dba Allergy Partners of the Piedmont

  • Allergy & Immunology Physician
  • Winston Salem, NC
  • NPI 1558351726
  NPD

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1750887915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603725",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603725",
            "telephone_number": "828-575-2625",
            "fax_number": "828-350-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1372 WESTGATE CENTER DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032932",
            "telephone_number": "336-659-4814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUTLAS",
        "first_name": "NICOLE",
        "middle_name": "MARIE LAWING",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NC",
            "license": "2021-01464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NNS226A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750887915",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750887915",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanna Koudele Koudele, DPT
• Lois Elinor Koufman, LPC
• Ana Elena Kouri, MD
• Brian Edward Kouri, MD
• Nicholas J Koutlas, MD
• Daniel Douglas Kovacs, M.D.
• Blake Ashley Kovner, ND
• Patrick Michael Kozak, M.D.
• Melissa Lee Kozakiewicz, M.D.
• Dorothy Jane Kozar, ACNP

• Allergy & Immunology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Allergy & Immunology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.