Kairos Medical Consulting, PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

KAIROS MEDICAL CONSULTING, PLLC

Practice address

3000 Bethesda PL Ste 104
Winston Salem, NC 27103-3323

Phone

(336) 293-4107

Fax

(949) 577-4324

NPI assigned

Dec 26, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Charles Dunham, MDNPI 1346268745

Title

Co-Owner

Phone

(336) 909-5939

Specialties & licenses 4

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: kendunham@kairos.kareodirect.com

Practitioners 4

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

• Charles Kendrick Dunham, M.D.

  • Psychiatry Physician
  • Virginia Beach, VA
  • NPI 1346268745

  Internal Medicine, NC

  Medicare reassignment NPD Authorized official
• Chue Lee Black, PHARM D, CPP

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Winston Salem, NC
  • NPI 1881108009
  NPD
• Obinna Ikwechegh, MD

  • Psychiatry Physician
  • Winston Salem, NC
  • NPI 1952582967
  NPD
• Leiloni Mulligan, LCSW

  • Clinical Social Worker
  • Winston Salem, NC
  • NPI 1790385326
  NPD

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

{
    "created_epoch": "1577318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630972800000",
    "number": "1669011565",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAIROS MEDICAL CONSULTING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-26",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A",
        "authorized_official_last_name": "DUNHAM",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "336-909-5939",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC MEDICAL BOARD PROFESSIONAL CORPORATION CERTIFICATE",
            "identifier": "256596",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kendunham@kairos.kareodirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging is a secure, electronic messaging system that enables transmission of protected health information (PHI) to other authenticated providers",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "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": []
}

• Michal Kaczor, MD
• Therese Kafant, MS, RD, LDN
• Nicholas Theodore Kafkas, DPM
• Assumpta Kagaba, FNP-C
• Frederic Ross Kahl, MD
• Kairos Wellness Initiative
• Ashley Elizabeth Kaiser, M.D.
• Arshadd Nayamvittil Kakrakandy, M.D.
• John Mason Kalada, MD
• Miranda Kalaskey, DDS

• 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 Sep 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.