2009-01873
Active
No
10/20/2009
03/02/2027
Active Supervisees
| Name | Type | Status | Approved | Inactive |
|
Adornetto, Renee
| Nurse Practitioner |
Active
|
08/29/2024
|
|
|
Barney, Julie Wood
| Nurse Practitioner |
Active
|
04/13/2026
|
|
|
Ervin, Alison Michelle
| Physician Assistant |
Active
|
04/14/2026
|
|
|
Fillmore, John Hudson
| Nurse Practitioner |
Active
|
05/19/2026
|
|
|
Gordon, Sarah Nicole
| Physician Assistant |
Active
|
04/16/2026
|
|
|
Guthrie, Joseph Clark
| Physician Assistant |
Active
|
03/01/2022
|
|
|
Hammond, Lindsay
| Nurse Practitioner |
Active
|
03/29/2026
|
|
|
Joines, Breland Meany
| Physician Assistant |
Active
|
04/08/2026
|
|
|
Kanin, Nicole Mary
| Physician Assistant |
Active
|
03/31/2026
|
|
|
Lizano, Michele Mariano
| Nurse Practitioner |
Active
|
06/22/2026
|
|
|
Phillips, Richard Brock
| Physician Assistant |
Active
|
12/06/2016
|
|
|
Redmond, Ashley Mclain
| Nurse Practitioner |
Active
|
07/25/2026
|
|
|
Scates, Tiare Rena
| Nurse Practitioner |
Active
|
06/01/2026
|
|
|
Simmons, Tangula Latrice
| Nurse Practitioner |
Active
|
03/20/2026
|
|
North Carolina Hospital Admitting Privileges
Out of State Active/Inactive Licenses
| State |
| Indiana |
| South Carolina |
| Virginia |
Out of Country Active/Inactive Licenses
Address
FastMed
310 S. Stratford Rd
Winston-Salem, NC 27103
336-714-5399
Information
Medical School
| School | Graduation |
| University of North Carolina at Chapel Hill School of Medicine | 1996 |
Post Graduate Training
"Last Year" does not necessarily mean that the licensee completed his/her training program. (In NC, a physician can be licensed without completing such a program.)
| Institution | Specialty | State, Country | Training Program | Last Year |
| University of North Carolina | Other - Faculty Development |
NC, US
| Fellowship | 2003 |
| Palmetto Richland Memorial Hospital | Sports Medicine |
SC, US
| Fellowship | 2000 |
| Riverside Regional Medical Center | Family Medicine |
VA, US
| Residency | 1999 |
Current Board Certification and Year of Certification/Recertification
Physicians should not list non-ABMS or non-AOA specialty boards unless the board meets the criteria set forth in the NC Medical Board’s Advertising and Publicity Position Statement.
| Primary/Subspecialty | Year |
| Family Medicine | 2025 |
| Sports Medicine | 2001 |
Area of Practice
| Area Of Practice | Primary |
| Family Medicine | |
| Occupational Medicine | Yes |
| Sports Medicine | |
| Urgent Care | |
Current Membership in Medical Professional Organizations
| Membership |
| American Academy of Family Physicians |
| American Medical Society for Sports Medicine |
| Society of Teachers of Family Medicine |
Honors & Awards
| Honor/Award | Given By | Date |
| None Reported |
Public Service
| Name of Clinic | Service Description | Date |
| None Reported |
Current Academic Appointments
| Title | Institution | City, State, Country |
| Assistant Professor | Wake Forest University School of Medicine |
Winston-Salem, NC, US
|
Publications
Section 1: Adverse Actions
North Carolina Medical Board Public Actions
| Date | Description | Link |
| None Reported |
Other Regulatory Board or Agency Public Actions
| Date | Name of Board/Agency | Action Taken | Link |
| None Reported |
Health Care Institution Suspensions and Revocations
| Date | Health Care Institution | Action Taken |
| None Reported |
Section 2: Administrative Actions
Actions listed in this section are considered non-disciplinary by the Board. In situations where
administrative actions are taken, the licensee may not have met certain statutory requirements or
may have failed to follow correct administrative procedures.
North Carolina Medical Board Reentry Agreement
| Date | Description | Link |
| None Reported |
North Carolina Special Purpose Licensing Agreement
| Date | Description | Link |
| None Reported |
Malpractice Information
The Board is currently reviewing the care that led to this payment.
| Incident Date | Payment Date | Area of Practice | City, State, Country | Response |
| None Reported |
Misdemeanor/DUI/DWI Conviction Information
| Conviction Date | Conviction | Jurisdiction | Sentence |
| None Reported |
Felony Conviction Information
| Conviction Date | Conviction | Jurisdiction | Sentence |
| None Reported |