Kathy Jackson Teasdall, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

9400157 Issued in NC

Practice address

755 Highland Oaks Dr
Ste 204
Winston Salem, NC 27103-7106

Phone

(336) 768-1037

Fax

(336) 768-9141

NPI assigned

Jun 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Otolaryngology

Education

University of Mississippi School of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Ear, Nose and Throat Associates, P.a.Group PAC ID 4486617032, 28 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

74.6 of 100Reported as group

Quality

31.13

Promoting interoperability

99

Improvement activities

40

Cost

85.04

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathyteasdall@penta.allscriptsdirect.net

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.

• Piedmont Ear, Nose & Throat Associates, P.a.

  • Otolaryngology Physician
  • Winston Salem, NC
  • NPI 1649216631
  Medicare reassignment Care Compare group NPD
• Charlotte Eye Ear Nose & Throat Associates, P.a.

  • Otolaryngology Physician
  • Winston Salem, NC
  • NPI 1710814405
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371686400000",
    "number": "1962448704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 HIGHLAND OAKS DR",
            "address_2": "STE 204",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271037106",
            "telephone_number": "336-768-1037",
            "fax_number": "336-768-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 HIGHLAND OAKS DR",
            "address_2": "STE 204",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271037106",
            "telephone_number": "336-768-1037",
            "fax_number": "336-768-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEASDALL",
        "first_name": "KATHY",
        "middle_name": "JACKSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2013-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "9400157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8982338",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Micah Nicole Teague, RD
• Sidney Calvin Teague II, DDS
• Van M Teague, OD
• Teamcare Inc.
• Grace Auton Teasdall, PA
• Robert Douglas Teasdall, MD
• Grace Alexandra Tedder
• Charles Herman Tegeler IV, MD
• Christopher Tegeler
• Debra Renee Tegeler, MD

• Otolaryngology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Otolaryngology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.