Individual provider Active NPI

Vickie Sink Spencer, FNP-BC

  • Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1992011423
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5004299 Issued in NC
Practice address
160 Charlois Blvd
Winston Salem, NC 27103-1522
Phone
(336) 768-5834
Fax
(336) 765-4889
NPI assigned
Aug 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5004299 NC Primary
Family Nurse Practitioner 363LF0000X 156013 NC

Addresses

Primary practice location

160 Charlois Blvd
Winston Salem, NC 27103-1522

Mailing address

160 Charlois Blvd
Winston Salem, NC 27103-1522
Phone (336) 768-5834

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vspencer20629@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120319000540 NC Practitioner - Nurse Practitioner 7416117015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1492 Rymco Dr
Winston Salem, NC 27103-2944
Phone (336) 765-5553

Hospital & facility affiliations

  • Novant Health Medical Park Hospital Hospital, Winston-Salem, NC, CCN 340148

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5004299NCMDNurse Practitioner
156013NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Oct 12, 2015 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Oct 12, 2015 Accepting new patients

Locations

2290 Remount Rd
Gastonia, NC 28054
Phone (704) 316-4979

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

1492 Rymco Dr
Winston Salem, NC 27103
Phone (336) 499-1820

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

2025 Frontis Plaza Blvd
Ste 120
Winston Salem, NC 27103
Phone (336) 277-2200

190 Kimel Park Dr
Ste 120
Winston Salem, NC 27103
Phone (336) 277-2200

Interoperability endpoints

  • Direct secure messaging: vspencer20629@direct.novanthealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1282348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1992011423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 CHARLOIS BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031522",
            "telephone_number": "336-768-5834",
            "fax_number": "336-765-4889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 CHARLOIS BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031522",
            "telephone_number": "336-768-5834",
            "fax_number": "336-765-4889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "VICKIE",
        "middle_name": "SINK",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-21",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5004299",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "156013",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vspencer20629@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "160 Charlois Blvd",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271031522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.