Individual provider Active NPI

Kendall Felipe Bonot, PA-C

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1487166906
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-08760 Issued in NC
Practice address
3101 John Humphries Wynd
Raleigh, NC 27612-5302
Phone
(919) 881-8272
NPI assigned
Oct 25, 2017
Last updated
Jul 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601008408 MI
Physician Assistant 363A00000X 0010-08760 NC Primary

Addresses

Primary practice location

3101 John Humphries Wynd
Raleigh, NC 27612-5302

Mailing address

3101 John Humphries Wynd
Raleigh, NC 27612-5302
Phone (919) 881-8272

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190417002368 NC Practitioner - Physician Assistant 1759646888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5601008408MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Triangle Arthritis and Rheumatology Associates CurrentSince Jul 25, 2021 Accepting new patients
Healthfirst Urgent Care PC CurrentSince Feb 11, 2019 Accepting new patients
Healthfirst Primary Care PC CurrentSince Feb 11, 2019 Accepting new patients

Locations

3101 John Humphries Wynd
Raleigh, NC 27612
Phone (919) 881-8272

3011B Raleigh Road Pkwy W
Wilson, NC 27896
Phone (252) 293-1010

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1487166906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 JOHN HUMPHRIES WYND",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125302",
            "telephone_number": "919-881-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 JOHN HUMPHRIES WYND",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125302",
            "telephone_number": "919-881-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONOT",
        "first_name": "KENDALL",
        "middle_name": "FELIPE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-25",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008408",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.