Poonam Kushwaha

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5022772 Issued in NC

Practice address

1007 Walker Ave
Greensboro, NC 27403

Phone

(336) 302-8183

NPI assigned

Jul 1, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pkushwaha783989@direct.novanthealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carolina Medicorp Enterprises, LLC

  • Urgent Care Clinic/Center
  • Charlotte, NC
  • NPI 1760950646

  NC

  Medicare reassignment Care Compare group NPD
• Carolina Medicorp Enterprises, LLC

  • Urgent Care Clinic/Center
  • Asheville, NC
  • NPI 1235014796
  NPD
• Carolina Medicorp Enterprises Inc

  • Pediatrics Physician
  • Charlotte, NC
  • NPI 1417497504
  NPD (past)

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1477398477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601843",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601843",
            "telephone_number": "336-867-4310",
            "fax_number": "336-867-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 WALKER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27403",
            "telephone_number": "336-302-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSHWAHA",
        "first_name": "POONAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "321554",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5022772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baljinder Kumar, M.D.
• Renee Antoinette Kuneff, D.O.
• Cassie Lynn Kuppelweiser, PHARMD
• Mary Beth Kureczka, PA
• Jonathan Michael Kurkoski, PHARM. D
• Katherine Kussler
• Gary Robert Kuzma, MD
• Kevin R Kuzma, MD
• Thomas Kwapil, PH.D.
• Hyun-Soon Ellen Kwark, M.D.

• Nurse Practitioner in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.