Individual provider Active NPI

Andreas D Runheim, M.D.

  • Neurology Physician
  • Winston Salem, NC
National Provider Identifier
1811948136
Registry record updated Mar 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
200401571 Issued in NC
Practice address
3333 Brookview Hills Blvd
Suite 104
Winston-Salem, NC 27103-5661
Phone
(336) 760-3007
Fax
(336) 760-9334
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2015

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 200401571 NC
Neurology Physician 2084N0400X 200401571 NC Primary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 200401571 NC
Neuromuscular Medicine (Psychiatry & Neurology) Physician 2084N0008X 200401571 NC
Diagnostic Neuroimaging (Psychiatry & Neurology) Physician 2084D0003X 200401571 NC
Clinical Neurophysiology Physician 2084N0600X 200401571 NC
Neurodevelopmental Disabilities Physician 2084P0005X 200401571 NC
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 200401571 NC
Vascular Neurology Physician 2084V0102X 200401571 NC

Addresses

Primary practice location

3333 Brookview Hills Blvd
Suite 104
Winston-Salem, NC 27103-5661

Mailing address

3333 Brookview Hills Blvd
Suite 104
Winston-Salem, NC 27103-5661
Phone (336) 760-3007

Other identifiers 2

IdentifierTypeStateIssuer
5904556MedicaidNC
200401571OtherNCLICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060713000145 NC Practitioner - Neurology 5698788727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Spine and Neurology, PLLCGroup PAC ID 5395114300, 6 clinicians

Practice addresses (Care Compare)

280 Broad St
Suite a
Kernersville, NC 27284-2948
Phone (336) 761-4020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1571NCMDAddiction (Substance Use Disorder) Counselor
200401571NCMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Spine and Neurology, PLLC Neurology CurrentSince Jul 1, 2023 Accepting new patients

Locations

280 Broad St
Ste A
Kernersville, NC 27284
Phone (336) 277-6430

219 Moore Rd
King, NC 27021
Phone (336) 760-3007

1370 Piedmont Dr
Lexington, NC 27295

2605 Blue Ridge Rd
Ste 330
Raleigh, NC 27607
Phone (336) 575-4351

3333 Brookview Hills Blvd
Ste 104
Winston Salem, NC 27103
Phone (336) 760-3007

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426032000000",
    "number": "1811948136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BROOKVIEW HILLS BLVD",
            "address_2": "SUITE 104",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271035661",
            "telephone_number": "336-760-3007",
            "fax_number": "336-760-9334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BROOKVIEW HILLS BLVD",
            "address_2": "SUITE 104",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271035661",
            "telephone_number": "336-760-3007",
            "fax_number": "336-760-9334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNHEIM",
        "first_name": "ANDREAS",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2015-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "200401571",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "200401571",
            "primary": true
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NC",
            "license": "200401571",
            "primary": false
        },
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "NC",
            "license": "200401571",
            "primary": false
        },
        {
            "code": "2084D0003X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Diagnostic Neuroimaging",
            "state": "NC",
            "license": "200401571",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NC",
            "license": "200401571",
            "primary": false
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": "NC",
            "license": "200401571",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "NC",
            "license": "200401571",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "NC",
            "license": "200401571",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5904556",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "200401571",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.