NPIMap

Organization Active NPI

Certus Psychiatry and Integrated Care PLLC

  • Psychiatry Physician
  • Winston Salem, NC
National Provider Identifier
1609317569
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
200900831 Issued in NC
Legal business name
CERTUS PSYCHIATRY AND INTEGRATED CARE PLLC
Practice address
1255 Creekshire Way
Suite 270
Winston Salem, NC 27103-3059
Phone
(954) 658-9768
NPI assigned
Mar 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Authorized official

Name
Gisela Kohl, MD
Title
President
Phone
(954) 658-9768

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 200900831 NC Primary
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

1255 Creekshire Way
Suite 270
Winston Salem, NC 27103-3059

Mailing address

1255 Creekshire Way
Suite 270
Winston Salem, NC 27103-3059
Phone (336) 701-3111

Other practice location 1

1350 Sunday Dr
Raleigh, NC 27607-5196
Phone (336) 701-3111

Other names 1

  • CPIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171030000239 NC Part B Supplier - Clinic/Group Practice 0244506756 Receives reassigned benefits from 20 practitioners
Practice locations: Winston Salem, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2262936Certus Psychiatry and Integrated Care1350 Sunday Dr Ste 101, Raleigh, NC 27607Certificate of waiverJun 20, 2028

National Provider Directory

National Provider Directory

Locations

1350 Sunday Dr
#101
Raleigh, NC 27607

1255 Creekshire Way
Ste 290
Winston Salem, NC 27103
Phone (336) 659-2663

1255 Creekshire Way
Ste 270
Winston Salem, NC 27103
Phone (336) 701-3111

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1489276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744329600000",
    "number": "1609317569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 CREEKSHIRE WAY",
            "address_2": "SUITE 270",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033059",
            "telephone_number": "336-701-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 CREEKSHIRE WAY",
            "address_2": "SUITE 270",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033059",
            "telephone_number": "954-658-9768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 Sunday Dr",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276075196",
            "country_code": "US",
            "telephone_number": "336-701-3111",
            "fax_number": "888-757-4153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CERTUS PSYCHIATRY AND INTEGRATED CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-12",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A",
        "authorized_official_last_name": "KOHL",
        "authorized_official_first_name": "GISELA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-658-9768",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "200900831",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CPIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CPIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.