Individual provider Active NPI

Kianna Wood Sebastian, PA-C

  • Medical Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1851744841
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-06599 Issued in NC
Practice address
145 Kimel Park Dr Ste 120
Winston Salem, NC 27103-6983
Phone
(336) 778-7564
NPI assigned
Jul 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-06599 NC
Medical Physician Assistant 363AM0700X 0010-06599 NC Primary

Addresses

Primary practice location

145 Kimel Park Dr Ste 120
Winston Salem, NC 27103-6983

Mailing address

145 Kimel Park Dr Ste 120
Winston Salem, NC 27103-6983
Phone (336) 778-7564

Other practice location 1

1950 S Hawthorne Rd
Winston Salem, NC 27103-3912
Phone (336) 718-8386

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160830003080 NC Practitioner - Physician Assistant 6800182817 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1750 Kernersville Med PK
Kernersville, NC 27284-7146
Phone (336) 564-4727

1750 Kernersville Medical Pkwy
Kernersville, NC 27284-7146
Phone (336) 564-4866

1950 S Hawthorne Rd
Winston Salem, NC 27103-3912
Phone (336) 718-8386

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 277-1717

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

6915 Village Medical Cir
Clemmons, NC 27012-8002
Phone (336) 718-7080

Hospital & facility affiliations

  • Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014
  • Novant Health Medical Park Hospital Hospital, Winston-Salem, NC, CCN 340148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Nov 30, 2024 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Nov 30, 2024 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

1950 S Hawthorne Rd
Winston Salem, NC 27103
Phone (336) 718-0600

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: kwood324877@direct.novanthealth.org

Organizations & group practices 5

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": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1851744841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 KIMEL PARK DR STE 120",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036983",
            "telephone_number": "336-778-7564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 KIMEL PARK DR STE 120",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036983",
            "telephone_number": "336-778-7564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1950 S Hawthorne Rd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271033912",
            "country_code": "US",
            "telephone_number": "336-718-8386",
            "fax_number": "336-718-0290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEBASTIAN",
        "first_name": "KIANNA",
        "middle_name": "WOOD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06599",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-06599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.