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NICOLE MARIE FAMA MD
NPI 1649074634
Student in an Organized Health Care Education/Training Program in Winston Salem, NC

Active since April 01, 2025PECOS Enrolled
1920 W 1ST ST FL 3, WINSTON SALEM, NC 27104(336) 716-4479 Get Directions Write a Review

NPPES record last updated: April 1, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Nicole Marie Fama Md NPPES

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

NICOLE MARIE FAMA MD (NPI 1649074634) 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 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649074634
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameNICOLE MARIE FAMACredential: MD
Location Address1920 W 1ST ST FL 3Winston Salem, NC 27104-4220
Mailing Address609 Club CirDaniels, WV 25832-9217 · (304) 573-1567
Phone(336) 716-4479
Sole ProprietorYes
Enumeration DateApril 1, 2025
NPPES CertifiedApril 1, 2025
✔ NPI 1649074634 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.

1920 W 1ST ST FL 3, Winston Salem, NC 27104
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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)

Nicole Marie Fama Md 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 19

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

CHRISTOPHER MICHAEL NELSON M.D.
Family Medicine (Sports Medicine)
1920 W 1ST ST FL 3
WINSTON SALEM, NC 27104
Forsyth County (336) 716-4479
RYAN PHILLIP MACDONALD
Student in an Organized Health Care Education/Training Program
1920 W 1ST ST FL 3
WINSTON SALEM, NC 27104
Forsyth County (336) 716-4479
RILEY JAMES COON
Student in an Organized Health Care Education/Training Program
1920 W 1ST ST FL 3
WINSTON SALEM, NC 27104
Forsyth County (336) 716-4479
SUKHDEV SINGH BRAR DO
Student in an Organized Health Care Education/Training Program
1920 W 1ST ST FL 3
WINSTON SALEM, NC 27104
Forsyth County (336) 716-4479
MATTHEW THOMAS USEVITCH MD
Student in an Organized Health Care Education/Training Program
1920 W 1ST ST FL 3
WINSTON SALEM, NC 27104
Forsyth County (336) 716-4479
VASHTI KHAVITA SHIWMANGAL
Student in an Organized Health Care Education/Training Program
1920 W 1ST ST FL 3
WINSTON SALEM, NC 27104
Forsyth County (336) 716-4479
MR. CAMDEN AUSTIN RICHARDSON DO
Student in an Organized Health Care Education/Training Program
1920 W 1ST ST FL 3
WINSTON SALEM, NC 27104
Forsyth County (336) 716-4479
ROBERT EMMET GALLIVAN MD
Student in an Organized Health Care Education/Training Program
1920 W 1ST ST FL 3
WINSTON SALEM, NC 27104
Forsyth County (336) 716-4479

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 Nicole Fama's NPI number?

The NPI number for Nicole Fama is 1649074634. It was assigned to this individual provider in the NPPES registry on April 1, 2025.

Where is Nicole Fama located?

Nicole Fama practices at 1920 W 1st St Fl 3, Winston Salem, NC 27104. The listed phone number is (336) 716-4479.

What is Nicole Fama's specialty?

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

Is Nicole Fama enrolled in Medicare?

Yes. Nicole Fama is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nicole Fama was last updated on April 1, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.