Kairos Wellness Initiative

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

KAIROS WELLNESS INITIATIVE

Practice address

3000 Bethesda PL Ste 202
Winston Salem, NC 27103-3324

Phone

(336) 293-4107

Fax

(949) 577-4324

NPI assigned

Jul 26, 2021

Last updated

Jul 26, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Obinna Ikwechegh, MDNPI 1952582967

Title

Owner

Phone

(336) 293-4107

Specialties & licenses 1

Addresses

Other identifiers 4

Electronic endpoints 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Obinna Ikwechegh, MD

  • Psychiatry Physician
  • Winston Salem, NC
  • NPI 1952582967
  NPD Authorized official
• Chue Lee Black, PHARM D, CPP

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Winston Salem, NC
  • NPI 1881108009
  NPD
• Leiloni Mulligan, LCSW

  • Clinical Social Worker
  • Winston Salem, NC
  • NPI 1790385326
  NPD
• Charles Kendrick Dunham, M.D.

  • Psychiatry Physician
  • Virginia Beach, VA
  • NPI 1346268745
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1417620527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 BETHESDA PL STE 104",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033323",
            "telephone_number": "336-293-4107",
            "fax_number": "949-577-4324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 BETHESDA PL STE 202",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033324",
            "telephone_number": "336-293-4107",
            "fax_number": "949-577-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAIROS WELLNESS INITIATIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A",
        "authorized_official_last_name": "IKWECHEGH",
        "authorized_official_first_name": "OBINNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-293-4107",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEILONI MULLIGAN",
            "identifier": "1790385326",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHUE BLACK",
            "identifier": "1881108009",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OBINNA IKWECHEGH",
            "identifier": "1952582967",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHARLES DUNHAM",
            "identifier": "1346268745",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@kairosmedicalconsult.org",
            "affiliation": "Y",
            "endpointDescription": "Business Email",
            "affiliationName": "Kairos Medical Consulting, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3000 Bethesda Pl Ste 104",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271033323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Therese Kafant, MS, RD, LDN
• Nicholas Theodore Kafkas, DPM
• Assumpta Kagaba, FNP-C
• Frederic Ross Kahl, MD
• Kairos Medical Consulting, PLLC
• Ashley Elizabeth Kaiser, M.D.
• Arshadd Nayamvittil Kakrakandy, M.D.
• John Mason Kalada, MD
• Miranda Kalaskey, DDS
• Suneetha Reedy Kalathoor, MD

• Psychiatry Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.