Individual provider Active NPI

Victor T Adkisson, MD

  • Internal Medicine Physician
  • Winston Salem, NC
National Provider Identifier
1912058553
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9400185 Issued in NC
Practice address
3333 Silas Creek Pkwy
Attn Ipof
Winston Salem, NC 27103-3013
Phone
(336) 718-7080
Fax
(336) 718-9622
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9400185 NC Primary

Addresses

Primary practice location

3333 Silas Creek Pkwy
Attn Ipof
Winston Salem, NC 27103-3013

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 718-7080

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vadkisson5493@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: vadkisson5493@direct.novanthealth.org

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1912058553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-718-7080",
            "fax_number": "336-718-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SILAS CREEK PKWY",
            "address_2": "ATTN IPOF",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "telephone_number": "336-718-7080",
            "fax_number": "336-718-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADKISSON",
        "first_name": "VICTOR",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2023-03-07",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9400185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vadkisson5493@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "3333 Silas Creek Pkwy",
            "address_2": "Attn IPOF",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271033013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.