Sandra Kolb, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5014996 Issued in NC

Practice address

413 Owen Dr Ste 101
Fayetteville, NC 28304-3490

Phone

(910) 491-3947

Fax

(910) 491-5691

NPI assigned

Aug 25, 2021

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Universal Health CorporationGroup PAC ID 5597912626, 120 clinicians

Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vidant Roanoke Chowan Hospital Hospital, Ahoskie, NC, CCN 340099

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment Care Compare group NPD
• Universal Health Corporation

  • Internal Medicine Physician
  • Roanoke, VA
  • NPI 1407117625

  NC

  Medicare reassignment Care Compare group NPD
• Renew Counseling Center of NC LLC

  • Physician Assistant
  • Fayetteville, NC
  • NPI 1528470325
  Medicare reassignment NPD
• Sandra Gail Kolb Family Practice

  • Primary Care Clinic/Center
  • Fayetteville, NC
  • NPI 1710603014
  NPD Authorized official
• Pai Participant 29, P.C.

  • Geriatric Medicine (Internal Medicine) Physician
  • Lexington, NC
  • NPI 1245813757
  NPD

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

• East Carolina Health

  • General Acute Care Hospital
  • Ahoskie, NC
  • NPI 1467441394
  Care Compare affiliation

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1790452076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 OWEN DR STE 101",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043490",
            "telephone_number": "910-491-3947",
            "fax_number": "910-491-5691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 OWEN DR STE 101",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043490",
            "telephone_number": "910-491-3947",
            "fax_number": "910-491-5691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLB",
        "first_name": "SANDRA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "VA",
            "license": "0024182510",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5014996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.eventuswholehealth.com",
            "affiliation": "N",
            "endpointDescription": "company websit",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "main URL",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "company direct",
            "address_1": "101 Cabarrus Ave E Ste 200",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280253781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bintee Koirala
• Audrey Kokidko, LCSWA
• Emmanuel Ebuka Kokori, M.D.
• Olajide L Kolawole, P.T.
• Olasunkanmi Abimbola Kolawole, MD,MPH
• Patrick Kolstee
• Shyam Komandur, MD
• Mabel Aye Aye Myaing Kong
• Monica Koo, PHARMD
• Domonique Battle Koomson

• Family Nurse Practitioner in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; 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.