NPIMap

Individual provider Active NPI

Vallathucherry Chakalakumbil Harish, MD

  • Hematology & Oncology Physician
  • High Point, NC
National Provider Identifier
1770520199
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
200300155 Issued in NC
Practice address
302 Westwood Ave
High Point, NC 27262-4324
Phone
(336) 781-4080
Fax
(336) 781-4081
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 200300155 NC Primary

Addresses

Primary practice location

302 Westwood Ave
High Point, NC 27262-4324

Mailing address

624 Quaker LN
Ste. 207C
High Point, NC 27262-3832
Phone (336) 883-2500

Other identifiers 1

IdentifierTypeStateIssuer
5903850MedicaidNC

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
I20060807000235 NC Practitioner - Hematology/OncologyPractitioner - Internal Medicine 4981607223 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 1992
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

  • High Point Regional Health System Hospital, High Point, NC, CCN 340004
  • 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
200300155NCMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Sep 1, 2018 Accepting new patients
Wake Forest Health Network, LLC CurrentSince Aug 1, 2006 Accepting new patients
Wake Forest Health Network LLC Current Accepting new patients
Wake Forest Health Network LLC CurrentSince Aug 1, 2006 Accepting new patients

Locations

810 N Lindsay St
High Point, NC 27262
Phone (336) 802-2060

302 Westwood Ave
High Point, NC 27262
Phone (336) 781-4080

624 Quaker Ln
Ste 207C
High Point, NC 27262
Phone (336) 883-2500

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

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

Interoperability endpoints

  • Direct secure messaging: vharish2754835@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 19

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.

View all 19

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1770520199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 QUAKER LN",
            "address_2": "STE. 207C",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272623832",
            "telephone_number": "336-883-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 WESTWOOD AVE",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272624324",
            "telephone_number": "336-781-4080",
            "fax_number": "336-781-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARISH",
        "first_name": "VALLATHUCHERRY",
        "middle_name": "CHAKALAKUMBIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "200300155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903850",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.