Active NPI
Kristie Dawn Bonnett, N.P
- Nurse Practitioner
- Winston Salem, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5001437
- Practice address
- 1950 S Hawthorne Rd
Winston Salem, NC 27103-3912 - Phone
- (336) 718-8386
- Fax
- (336) 718-0290
- NPI assigned
- Jul 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 005001437 | NC | |
| Nurse Practitioner | 363L00000X | 5001437 | NC | Primary |
Addresses
Primary practice location
1950 S Hawthorne Rd
Winston Salem, NC 27103-3912
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 718-7080
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0050 01437 | Other | NC | MEDICAL BOARD LICENSE |
| 2005010216 | Other | FL | CERTIFICATION |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kbonnett39541@direct.novanthealth.org |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1010 Bethesda CT
Winston Salem, NC 27103-3019
Phone (336) 277-6000
Hospital & facility affiliations
- Novant Health Forsyth Medical Center
- Novant Health Medical Park Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01437 | NC | MD | Marriage & Family Therapist |
| 5001437 | NC | MD | Nurse Practitioner |
| 005001437 | NC | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Medical Group Inc | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Past | Accepting new patients |
Locations
5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441
1950 S Hawthorne Rd
Winston Salem, NC 27103
Phone (336) 718-0600
390 W Salem Ave
Winston Salem, NC 27101
Phone (336) 721-2375
1010 Bethesda Ct
Winston Salem, NC 27103
Phone (336) 277-6000
2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300
Interoperability endpoints
- kbonnett39541@direct.novanthealth.org
Organizations & group practices 4
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.
-
- Neurology with Special Qualifications in Child Neurology Physician
- Charlotte, NC
- NPI 1366409492
-
- Obstetrics & Gynecology Physician
- Matthews, NC
- NPI 1386506137
-
- Registered Dietitian
- Clemmons, NC
- NPI 1295092856
-
- Internal Medicine Physician
- Charlotte, NC
- NPI 1134841802
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Winston Salem, NC
- NPI 1447200233
-
- General Acute Care Hospital
- Winston-Salem, NC
- NPI 1538111828
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603584000000",
"number": "1669401337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60447",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282600447",
"telephone_number": "336-718-7080",
"fax_number": "336-718-9622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1950 S HAWTHORNE RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271033912",
"telephone_number": "336-718-8386",
"fax_number": "336-718-0290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONNETT",
"first_name": "KRISTIE",
"middle_name": "DAWN",
"credential": "N.P",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-03",
"last_updated": "2020-10-25",
"certification_date": "2020-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NC",
"license": "005001437",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "5001437",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL BOARD LICENSE",
"identifier": "0050 01437",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFICATION",
"identifier": "2005010216",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kbonnett39541@direct.novanthealth.org",
"affiliation": "N",
"address_1": "1950 S Hawthorne Rd",
"city": "Winston Salem",
"state": "NC",
"country_code": "US",
"postal_code": "271033912",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
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 Oct 25, 2020; 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.