Individual provider Active NPI

Mary Katherine Adkins

  • Physician Assistant
  • High Point, NC
National Provider Identifier
1952062952
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4515 Premier Dr Ste 204
High Point, NC 27265-8356
Phone
(336) 802-2015
NPI assigned
Jan 3, 2022
Last updated
Feb 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NC Primary

Addresses

Primary practice location

4515 Premier Dr Ste 204
High Point, NC 27265-8356

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 716-1331

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
I20220127001689 NC Practitioner - Physician Assistant 6103218912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wake Forest University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wake Forest Health Network LLCGroup PAC ID 4183538895, 276 clinicians

Practice addresses (Care Compare)

4515 Premier Dr
High Point, NC 27265-8356

770 Highland Oaks Dr
Winston Salem, NC 27103-7105
Phone (336) 765-5250

905 Phillips Ave
High Point, NC 27262-7075
Phone (336) 802-2040

Medical Ctr Blvd
Winston Salem, NC 27157-0001

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest Health Network, LLC CurrentSince Feb 14, 2022 Accepting new patients
Wake Forest Health Network LLC CurrentSince Feb 14, 2022 Accepting new patients

Locations

4515 Premier Dr
Ste 204
High Point, NC 27265
Phone (336) 802-2015

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

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

Interoperability endpoints

  • Direct secure messaging: madkins815879@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 3

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 6

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": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1952062952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-716-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 PREMIER DR STE 204",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658356",
            "telephone_number": "336-802-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADKINS",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-03",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.