Active NPI
Khoua Alex Vang
- Nurse Practitioner
- Winston Salem, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5017254
- Practice address
- 3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013 - Phone
- (336) 718-7224
- Fax
- (336) 718-7598
- NPI assigned
- Nov 11, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | VANG-XFMC3 | NC | |
| Nurse Practitioner | 363L00000X | 5017254 | NC | Primary |
Addresses
Primary practice location
3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Mailing address
PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 718-7224
Other practice location 1
190 Kimel Park Dr # 155
Winston Salem, NC 27103-6946
Phone (336) 765-6637
Other practice location 2
152 E Kinderton Way Ste 101
Bermuda Run, NC 27006-7351
Phone (336) 893-3190
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
190 Kimel Park Dr
Suite 155
Winston Salem, NC 27103-6946
Phone (336) 765-6637
3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 718-5000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| VANG-XFMC3 | NC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Forsyth Memorial Hospital, Inc. | Current | Accepting new patients | |
| Forsyth Memorial Hospital Inc | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Forsyth Memorial Hospital, Inc. | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Forsyth Memorial Hospital, Inc | Past | Accepting new patients |
Locations
152 E Kinderton Way
Ste 101
Bermuda Run, NC 27006
Phone (336) 893-3180
6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473
291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181
5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441
3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800
175 Kimel Park Dr
Winston Salem, NC 27103
Phone (336) 718-1006
190 Kimel Park Dr
Ste 155
Winston Salem, NC 27103
Phone (336) 765-6637
2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300
Interoperability endpoints
- kvang887088@direct.novanthealth.org
Organizations & group practices 7
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.
-
- Family Medicine Physician
- Winston Salem, NC
- NPI 1104548874
-
- Neurology with Special Qualifications in Child Neurology Physician
- Charlotte, NC
- NPI 1366409492
-
- Neurology Physician
- Winston Salem, NC
- NPI 1972842086
-
- Cardiovascular Disease Physician
- Winston Salem, NC
- NPI 1932935475
-
- Obstetrics & Gynecology Physician
- Matthews, NC
- NPI 1386506137
-
- Neurological Surgery Physician
- Winston Salem, NC
- NPI 1497080006
-
- Family Medicine Physician
- Mount Airy, NC
- NPI 1295783108
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Winston Salem, NC
- NPI 1447200233
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736726400000",
"number": "1841908407",
"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",
"telephone_number": "336-718-7224",
"fax_number": "336-718-7598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 SILAS CREEK PKWY",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271033013",
"telephone_number": "336-718-7224",
"fax_number": "336-718-7598"
}
],
"practiceLocations": [
{
"address_1": "190 Kimel Park Dr # 155",
"address_purpose": "LOCATION",
"city": "Winston Salem",
"state": "NC",
"postal_code": "271036946",
"country_code": "US",
"telephone_number": "336-765-6637",
"fax_number": "336-765-6964",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "152 E Kinderton Way Ste 101",
"address_purpose": "LOCATION",
"city": "Bermuda Run",
"state": "NC",
"postal_code": "270067351",
"country_code": "US",
"telephone_number": "336-893-3190",
"fax_number": "336-893-3189",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VANG",
"first_name": "KHOUA",
"middle_name": "ALEX",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-11-11",
"last_updated": "2025-01-13",
"certification_date": "2025-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "VANG-XFMC3",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "5017254",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; 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.