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PEMBROKE NASH III
NPI 1063264356
Student in an Organized Health Care Education/Training Program in Winston Salem, NC

Active since April 02, 2024PECOS Enrolled
ONE MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157(336) 716-2011 Get Directions Write a Review

NPPES record last updated: April 2, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Pembroke Nash Iii NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEMBROKE NASH III (NPI 1063264356) is an individual student in an organized health care education/training program in Winston Salem, North Carolina and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063264356
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NamePEMBROKE NASH III
Location AddressONE MEDICAL CENTER BLVDWinston Salem, NC 27157-0001
Mailing AddressOne Medical Center BlvdWinston Salem, NC 27157-0001 · (336) 716-2011
Phone(336) 716-2011
Sole ProprietorNo
Enumeration DateApril 2, 2024
NPPES CertifiedApril 2, 2024
✔ NPI 1063264356 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

ONE MEDICAL CENTER BLVD, Winston Salem, NC 27157
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pembroke Nash Iii is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANNA LARUSSA MD
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (855) 799-0044
DR. JARED JOSEPH TUTTLE MD
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-4091
CESAR ANDRES URIZAR-GONZALEZ MD
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 713-7527
HOLDEN BRADLY LEWIS
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-7580
HONGSHENG LU MD
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 713-7527
RAED WALEED ALI ALKHADDASH
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-7548
IAN ALASDAIR SEDDON DO
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-4490
DR. KIMBERLY ANNE WAGGENER MD
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-4241

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pembroke Nash's NPI number?

The NPI number for Pembroke Nash is 1063264356. It was assigned to this individual provider in the NPPES registry on April 2, 2024.

Where is Pembroke Nash located?

Pembroke Nash practices at One Medical Center Blvd, Winston Salem, NC 27157. The listed phone number is (336) 716-2011.

What is Pembroke Nash's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Pembroke Nash enrolled in Medicare?

Yes. Pembroke Nash is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Pembroke Nash was last updated on April 2, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.