KRISTINE M BENNETT (NPI# 1649204041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649204041 |
| Entity Type | Individual |
| Full Name | KRISTINE M BENNETT |
| Credential | PA-C |
| Practice Address |
532 W Park Cir N Wilkesboro NC 28659-3547 |
| Mailing Address |
2020 Peace Haven Rd Winston Salem NC 27106-4851 |
| Practice Telephone | 3366676600 |
| Practice Fax Number | 3367482666 |
| Mailing Telephone | 3367681280 |
| Mailing Fax Number | 3367608443 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-10-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0010-04920 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS PROVIDER ID# | 0451514334 | 01 |
| IL | LICENSE | 85000828 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1450 Professional Park Dr Ste 150, Winston Salem, NC 271031307 | 3367242434 | 3366078061 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720592454 | Kristine Elizabeth Bennett | Dietitian, Registered | 125 Hospital Dr, Watertown, WI 53098-3303 | 2017-11-16 |
| Street Address |
532 W PARK CIR |
| City | N WILKESBORO |
| State | NC |
| Zip Code | 28659-3547 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013579689 | Lisa C Carr | Social Worker | 1400 Willow Ln # C61-2, North Wilkesboro, NC 28659 | 2019-07-03 |
| 1780141507 | Brenda Barber | Counselor | 200 Northview Plaza, North Wilkesboro, NC 28659 | 2019-02-28 |
| 1639696941 | Lifespan Incorporated | Community/Behavioral Health | 2070 River Road, North Wilkesboro, NC 28659 | 2017-08-28 |
| 1184146011 | Daymark Recovery Services Inc | Community/Behavioral Health | 200 C.c. Wright School Road, Classrooms 126, 127, North Wilkesboro, NC 28659 | 2017-07-12 |
| 1033568258 | Rgm Al Holdings, LLC | Assisted Living Facility | 240 Independence Ave, North Wilkesboro, NC 28659 | 2016-06-08 |
| 1376997999 | Hayden Church | Driver | 29 Boone Trail, North Wilkesboro, NC 28659 | 2016-04-20 |
| 1033563192 | Nathan Grant Davis | Emergency Medicine | Wake Forest Baptist Health- Wilkes Medical Center, 1370 W D St, North Wilkesboro, NC 28659 | 2016-04-14 |
| 1720425408 | Lindsay Brooke Spears | Dentist | 1915 West Park Drive Ste 104, Wilkes Public Health Dental West, North Wilkesboro, NC 28659 | 2013-06-04 |
| 1881983419 | Pruitthealth Hospice, Inc. | Hospice Care, Community Based | 902 West D St, Ste B, North Wilkesboro, NC 28659 | 2011-04-05 |
| 1275838096 | Barium Springs Home for Children | Community Based Residential Treatment Facility, Mental Illness | 517 Boston Ave, North Wilkesboro, NC 28659 | 2011-01-26 |
| Find all providers in zip 28659 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841274248 | Karla May Hennequin | Physician Assistant | 1370 W D St, N Wilkesboro, NC 28659-3506 | 2005-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538459 | Sarah Jane Lamanna | Physician Assistant | 3012 Bristol Creek Dr, Morrisville, NC 27560-7811 | 2020-11-04 |
| 1043819741 | Brad Russell Tolan | Physician Assistant | 211 Pinegate Cir Apt 12, Chapel Hill, NC 27514-2221 | 2020-10-22 |
| 1265030654 | Vanessa Vinson | Physician Assistant | 284 Lower Edgewood Rd, Candler, NC 28715-9285 | 2020-10-16 |
| 1649878810 | Courtney Michelle Watlington | Physician Assistant | 360 N Bennett St, Southern Pines, NC 28387-4813 | 2020-10-11 |
| 1669079034 | Christine Meyer | Physician Assistant | 2523 Creek Ridge Ln, Chapel Hill, NC 27514-7454 | 2020-10-07 |
| 1407453319 | Khyan Waddell | Physician Assistant | 127 Sneed Rd, Enfield, NC 27823-9589 | 2020-10-04 |
| 1053918979 | Amjad Ali | Physician Assistant | 730 Montlieu Ave, High Point, NC 27260-4000 | 2020-10-04 |
| 1104433382 | Aditi Bhattacharjee Sundaresan | Physician Assistant | 131 Mallard Ct, Chapel Hill, NC 27517-9104 | 2020-09-30 |
| 1689281933 | Kathryn Tarulli | Physician Assistant | 600 W Main St Apt 624, Durham, NC 27701-5005 | 2020-09-29 |
| 1205443991 | Kelsey Mendez | Physician Assistant | 105 Basket Oak Dr, Bunnlevel, NC 28323-9141 | 2020-09-26 |
| Find all providers with the same taxonomy | ||||
| City | N WILKESBORO |
| Zip Code | 28659 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.