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ISAAC JAMES KOLODITCH
NPI 1174191399
Student in an Organized Health Care Education/Training Program in Winston Salem, NC

Active since June 14, 2021PECOS Enrolled
475 VINE ST, WINSTON SALEM, NC 27101(941) 761-0409 Get Directions Write a Review

NPPES record last updated: June 14, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Isaac James Koloditch NPPES

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

ISAAC JAMES KOLODITCH (NPI 1174191399) is an individual student in an organized health care education/training program in Winston Salem, North Carolina and active in the NPI registry since June 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174191399
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameISAAC JAMES KOLODITCH
Location Address475 VINE STWinston Salem, NC 27101-4135
Mailing Address912 Madison AveWinston Salem, NC 27103-4542 · (941) 716-0409
Phone(941) 761-0409
Sole ProprietorYes
Enumeration DateJune 14, 2021
NPPES CertifiedJune 14, 2021
✔ NPI 1174191399 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.
475 VINE ST, Winston Salem, NC 27101
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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)

Isaac James Koloditch 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 17

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

DEVYN SMITH
Student in an Organized Health Care Education/Training Program
475 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-2011
GABRIELLA TAGHIAN
Student in an Organized Health Care Education/Training Program
475 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (781) 929-0888
FARAJI WOODSON
Student in an Organized Health Care Education/Training Program
475 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 686-1029
CHASE OLSON
Student in an Organized Health Care Education/Training Program
475 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-2011
NIKITHA JONA
Student in an Organized Health Care Education/Training Program
475 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (843) 260-7788
JACKSON NOWATZKE
Student in an Organized Health Care Education/Training Program
475 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-2011
ERIC ZENG
Student in an Organized Health Care Education/Training Program
475 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-2011
ALYSIA BELLA KOHRS
Student in an Organized Health Care Education/Training Program
475 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (918) 995-0008

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 Isaac Koloditch's NPI number?

The NPI number for Isaac Koloditch is 1174191399. It was assigned to this individual provider in the NPPES registry on June 14, 2021.

Where is Isaac Koloditch located?

Isaac Koloditch practices at 475 Vine St, Winston Salem, NC 27101. The listed phone number is (941) 761-0409.

What is Isaac Koloditch's specialty?

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

Is Isaac Koloditch enrolled in Medicare?

Yes. Isaac Koloditch is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Isaac Koloditch was last updated on June 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.