Individual provider Active NPI

Kristie Michelle Bonot, PA - C

  • Physician Assistant
  • Wilson, NC
National Provider Identifier
1922347749
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-04103 Issued in NC
Practice address
2503 Forest Hills Rd W Ste B
Wilson, NC 27893-3392
Phone
(252) 991-0555
NPI assigned
Feb 14, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-04103 NC Primary

Addresses

Primary practice location

2503 Forest Hills Rd W Ste B
Wilson, NC 27893-3392

Mailing address

2503 Forest Hills Rd W Ste B
Wilson, NC 27893-3392
Phone (252) 991-0555

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
I20130327000468 NC Practitioner - Physician Assistant 0143465955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Brody School of Medicine at East Carolina University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fastmed PCGroup PAC ID 9830540558, 174 clinicians

Practice addresses (Care Compare)

2503 Forest Hills Rd W
Suite B
Wilson, NC 27893-3392
Phone (252) 991-0555

2908 N Herritage St
Kinston, NC 28501-1580
Phone (252) 523-3111

7010 NC Hwy 751
Durham, NC 27707-5733
Phone (919) 313-3900

817 E Gannon Ave
Suite 104
Zebulon, NC 27597-8940
Phone (919) 375-1975

Merit-based Incentive Payment System (MIPS)

Final score
74.09 of 100Reported as group
Quality
65.78
Improvement activities
40
Cost
76.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fastmed Primary Care, P.C. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1360800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1922347749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2503 FOREST HILLS RD W STE B",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933392",
            "telephone_number": "252-991-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2503 FOREST HILLS RD W STE B",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933392",
            "telephone_number": "252-991-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONOT",
        "first_name": "KRISTIE",
        "middle_name": "MICHELLE",
        "credential": "PA - C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-14",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

Verify at the official NPI Registry.