NICOLE RYAN MACK MD
NPI 1891597399
Student in an Organized Health Care Education/Training Program in Winston Salem, NC
About Nicole Ryan Mack Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NICOLE RYAN MACK MD (NPI 1891597399) is an individual student in an organized health care education/training program in Winston Salem, North Carolina and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
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 Ryan Mack Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
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.
WINSTON-SALEM, NC 27157
WINSTON SALEM, NC 27157
WINSTON SALEM, NC 27157
WINSTON SALEM, NC 27157
WINSTON SALEM, NC 27157
WINSTON SALEM, NC 27157
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 Mack's NPI number?
The NPI number for Nicole Mack is 1891597399. It was assigned to this individual provider in the NPPES registry on March 25, 2025.
Where is Nicole Mack located?
Nicole Mack practices at 1 Medical Center Blvd, Winston Salem, NC 27157. The listed phone number is (336) 716-4498.
What is Nicole Mack'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 Mack enrolled in Medicare?
Yes. Nicole Mack is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Nicole Mack was last updated on March 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.
# Nicole Ryan Mack, MD · NPI 1891597399
Student in an Organized Health Care Education/Training Program provider in Winston Salem, North Carolina. Individual provider, active in the CMS NPPES registry since March 25, 2025.
## Identity
- **NPI:** 1891597399 (Entity type: Individual)
- **Enumerated:** March 25, 2025
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1 MEDICAL CENTER BLVD, Winston Salem, NC 27157-0001
- **Phone:** (336) 716-4498
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** March 25, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1891597399) · Data from the CMS NPPES public registry.