Individual provider Active NPI

Joylin Glenita Dsa, MD

  • Family Medicine Physician
  • Kernersville, NC
National Provider Identifier
1861629511
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2017-01733 Issued in NC
Practice address
291 Broad St
Kernersville, NC 27284-2932
Phone
(336) 993-8181
Fax
(336) 996-9539
NPI assigned
Jun 19, 2009
Last updated
Oct 26, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R2139 KY
Family Medicine Physician 207Q00000X MD446450 PA
Family Medicine Physician 207Q00000X 2017-01733 NC Primary

Addresses

Primary practice location

291 Broad St
Kernersville, NC 27284-2932

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 718-4820

Other practice location 1

27 Cjems Ln
Suite 4
Mifflintown, PA 17059-8384
Phone (201) 234-2907

Other practice location 2

27 Cjems Ln
Suite 4
Mifflintown, PA 17059-8384
Phone (201) 234-2907

Other identifiers 1

IdentifierTypeStateIssuer
7100126360MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdsa514908@direct.novanthealth.org

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
I20171030000914 NC Practitioner - Family Practice 3577688613 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

100 Robinhood Medical PLZ
Winston Salem, NC 27106-5476
Phone (336) 718-0800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital, Inc. Family Medicine Current Accepting new patients
Forsyth Memorial Hospital Inc. Family Medicine CurrentSince Nov 1, 2017 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Nov 1, 2017 Accepting new patients
Novant Medical Group, Inc. Past Accepting new patients
Forsyth Memorial Hospital, Inc Family Medicine Past Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

6915 Village Medical Cir
Clemmons, NC 27012
Phone (336) 718-1680

1750 Kernersville Medical Pkwy
Kernersville, NC 27284
Phone (336) 564-4000

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

100 Robinhood Medical Plz
Winston Salem, NC 27106
Phone (336) 718-0560

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

Interoperability endpoints

  • Direct secure messaging: jdsa514908@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1861629511",
    "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": "336-718-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 BROAD ST",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842932",
            "telephone_number": "336-993-8181",
            "fax_number": "336-996-9539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27 Cjems Ln",
            "address_2": "Suite 4",
            "address_purpose": "LOCATION",
            "city": "Mifflintown",
            "state": "PA",
            "postal_code": "170598384",
            "country_code": "US",
            "telephone_number": "201-234-2907",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "27 Cjems Ln",
            "address_2": "Suite 4",
            "address_purpose": "LOCATION",
            "city": "Mifflintown",
            "state": "PA",
            "postal_code": "170598384",
            "country_code": "US",
            "telephone_number": "201-234-2907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DSA",
        "first_name": "JOYLIN",
        "middle_name": "GLENITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-19",
        "last_updated": "2020-10-26",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "R2139",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD446450",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2017-01733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100126360",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdsa514908@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "27 Cjems Ln",
            "address_2": "Suite 4",
            "city": "Mifflintown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170598384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

Verify at the official NPI Registry.