Individual provider Active NPI

Wanda Kotvan Panosh, M.D.

  • Internal Medicine Physician
  • Greensboro, NC
National Provider Identifier
1992761993
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25824 Issued in NC
Practice address
3803 Robert Porcher Way
Greensboro, NC 27410-2191
Phone
(336) 286-3442
NPI assigned
Apr 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25824 NC
Internal Medicine Physician 207R00000X 25824 NC Primary

Addresses

Primary practice location

3803 Robert Porcher Way
Greensboro, NC 27410-2191

Mailing address

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-7000

Other identifiers 5

IdentifierTypeStateIssuer
17653OtherNCPARTNERS MEDICARE
5686054OtherNCAETNA
65209OtherNCBCBS NC
74378OtherNCMEDCOST
8965209MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wpanosh3078@direct.conehealth.com Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100708000438 NC Practitioner - Internal MedicinePractitioner - Pediatric Medicine 7911038963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Pittsburgh School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moses Cone Medical Services IncGroup PAC ID 2769395458, 214 clinicians

Practice addresses (Care Compare)

3803 Robert Porcher Way
Greensboro, NC 27410-2191
Phone (336) 286-3442

520 N Elam Ave
Greensboro, NC 27403-1127
Phone (336) 547-1700

940 Golf House CT E
Whitsett, NC 27377-9296
Phone (336) 449-9848

Hospital & facility affiliations

  • Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31744NCMDInternal Medicine Physician
25824NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Moses Cone Medical Services, Inc. Internal Medicine CurrentSince May 18, 2010 Accepting new patients
Moses Cone Medical Services, Inc. CurrentSince May 18, 2010 Accepting new patients

Locations

1126 N Church St
Ste 300
Greensboro, NC 27401
Phone (336) 547-1700

3803 Robert Porcher Way
Greensboro, NC 27410
Phone (336) 286-3442

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

940 Golf House Ct E
Whitsett, NC 27377
Phone (336) 449-9848

Interoperability endpoints

  • Direct secure messaging: wpanosh3078@direct.conehealth.com

Organizations & group practices 2

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1992761993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011004",
            "telephone_number": "336-832-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3803 ROBERT PORCHER WAY",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102191",
            "telephone_number": "336-286-3442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANOSH",
        "first_name": "WANDA",
        "middle_name": "KOTVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "25824",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "25824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS MEDICARE",
            "identifier": "17653",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5686054",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "65209",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "74378",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8965209",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wpanosh3078@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Direct Message",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3803 Robert Porcher Way",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274102191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.