Individual provider Active NPI

John Vernon Hillson, DNP

  • Radiation Oncology Physician
  • Winston-Salem, NC
National Provider Identifier
1922880665
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
5018931 Issued in NC
Practice address
Medical Center Boulevard
Radiation Oncology
Winston-Salem, NC 27157
Phone
(336) 713-3600
Fax
(336) 713-6622
NPI assigned
Oct 17, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X 5018931 NC Primary

Addresses

Primary practice location

Medical Center Boulevard
Radiation Oncology
Winston-Salem, NC 27157

Mailing address

5408 Hough Rd
Hillsborough, NC 27278-8312
Phone (919) 636-1919

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
I20240729000020 NC Practitioner - Nurse Practitioner 2567908460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5018931NCMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences Single Specialty CurrentSince Apr 28, 2024 Accepting new patients

Locations

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Interoperability endpoints

  • Direct secure messaging: jhillson2791848@carolinashealthcaresystem.direct-ci.com

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 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": "1697500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1922880665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5408 HOUGH RD",
            "city": "HILLSBOROUGH",
            "state": "NC",
            "postal_code": "272788312",
            "telephone_number": "919-636-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BOULEVARD",
            "address_2": "RADIATION ONCOLOGY",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27157",
            "telephone_number": "336-713-3600",
            "fax_number": "336-713-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLSON",
        "first_name": "JOHN",
        "middle_name": "VERNON",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "NC",
            "license": "5018931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston-Salem, NC

Sources for this page

Verify at the official NPI Registry.