Kristine M Bennett, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-04920 Issued in NC

Practice address

152 Sherlock Dr
Statesville, NC 28625-1916

Phone

(704) 838-8210

Fax

(704) 924-5359

NPI assigned

Jul 10, 2006

Last updated

Dec 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Physician Assistant

Education

Mid West Medical College, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Piedmont Healthcare PAGroup PAC ID 9638070683, 226 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbennett@directaddress.net
• Direct secure messaging: kbennett764189@direct.novanthealth.org
• Direct secure messaging: kristine.bennett@qdp.emadirect.md

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.

• Piedmont Healthcare, P.a.

  • Internal Medicine Physician
  • Statesville, NC
  • NPI 1912999897
  Medicare reassignment Care Compare group NPD
• Carolina Medicorp Enterprises, LLC

  dba Novant Health GoHealth Urgent Care

  • Urgent Care Clinic/Center
  • Charlotte, NC
  • NPI 1760950646
  Medicare reassignment Care Compare group
• Skin Surgery Center PA

  • Dermatology Physician
  • Winston Salem, NC
  • NPI 1649237082
  Medicare reassignment NPD
• Carolina Medicorp Enterprises, LLC

  dba Novant Health GoHealth Urgent Care

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

  dba Novant Health GoHealth Urgent Care

  • Urgent Care Clinic/Center
  • Huntersville, NC
  • NPI 1972488427
  NPD
• Piedmont Healthcare, PA

  • Durable Medical Equipment & Medical Supplies
  • Statesville, NC
  • NPI 1639041320
  NPD
• Triad Dermatology PA

  • Dermatology Physician
  • Winston Salem, NC
  • NPI 1699836908
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1649204041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845",
            "telephone_number": "704-873-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 SHERLOCK DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286251916",
            "telephone_number": "704-838-8210",
            "fax_number": "704-924-5359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 Professional Park Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271031307",
            "country_code": "US",
            "telephone_number": "336-724-2434",
            "fax_number": "336-607-8061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "532 W Park Cir",
            "address_purpose": "LOCATION",
            "city": "N Wilkesboro",
            "state": "NC",
            "postal_code": "286593547",
            "country_code": "US",
            "telephone_number": "336-667-6600",
            "fax_number": "336-748-2666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "KRISTINE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID#",
            "identifier": "0451514334",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "85000828",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Makalyn Alyson Benge
• Benjamin E Dunlap MD PA
• Hunter Mackenzie Benjamin, BCBA, LBA
• Bennett Counseling and Wellness, PLLC
• Kelly A Bennett, PA
• William Bennett, LCMHCA
• Lisa Renaye Bentley, LPC
• Ralph L Bentley, M.D.
• Michelle Philbrook Benton, LCMHCS, LCAS
• Laura Bernal-Corzo

• Physician Assistant in Statesville, NC
• Providers in Statesville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.