BERTILLE KUISSO PONKAM


Address: 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103-1368
Phone: 2036835946

BERTILLE KUISSO PONKAM (NPI# 1265054779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1265054779
Entity Type Individual
Full Name BERTILLE KUISSO PONKAM
Practice Address 615 Saint George Square Ct Ste 300
Winston Salem
NC 27103-1368
Mailing Address 1000 Lafayette Blvd Ste 1100
Bridgeport
CT 06604-4710
Practice Telephone 2036835946
Practice Fax Number 2033064040
Mailing Telephone 2036835946
Mailing Fax Number 2033064040
Enumeration Date 2020-05-07
Last Update Date 2020-05-07
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 174H00000X Health Educator Other Service Providers

Office Location

Street Address 615 SAINT GEORGE SQUARE CT STE 300
City WINSTON SALEM
State NC
Zip Code 27103-1368

Providers in the same location

NPI Name Taxonomy Address Enumeration
1295759538 Alisha Beth Benner Internal Medicine 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103-1368 2006-07-27
1730710328 Counseling With A Purpose, Pllc Clinic/Center 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103-1368 2020-01-31
1316578404 Hines Family Services Inc Case Management 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103-1368 2020-01-28
1629608849 Amc Health North Carolina Inc Durable Medical Equipment & Medical Supplies 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103-1368 2020-01-16
1528607207 Medicaid Travel, Inc. Meals 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103-1368 2019-12-30
1285132514 Merida Amarilis Valera Counselor 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103 2018-02-01
1568971083 Gail Williams-booker Nurse Practitioner 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103-1368 2017-09-27
1255794855 Cheri Taylor Nurse Practitioner 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103-1368 2016-03-31
1760894596 Jordan Harrold Social Worker 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103-1368 2014-05-28
1003199928 Felicia Patterson Washington Nurse Practitioner 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103 2011-09-27
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1124648126 Kelly Anne Wales Pharmacist 3917-a Westpoint Boulevard, Winston-salem, NC 27103 2020-04-20
1386281533 Elena Mcginty Nurse Practitioner 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 2019-12-06
1992359442 Madeline Pryor Pharmacist 255 Charlois Drive, Winston Salem, NC 27103 2019-08-01
1215599584 Palmetto Oxygen LLC Durable Medical Equipment & Medical Supplies 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 2019-07-07
1548734718 Trivy Johnson Specialist 1384-b Westgate Center Dr., Winston Salem, NC 27103 2019-01-21
1447745047 Novant Health Rehabilitation Hospital of Winston-salem, LLC Rehabilitation Hospital 2475 Hillcrest Center Circle, Winston Salem, NC 27103 2018-06-26
1346740206 Joseph Miller Physical Therapist 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 2018-02-17
1548779101 Kristin Blow Counselor 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 2017-09-27
1891213443 Alisha Dawn Wilson Occupational Therapy Assistant 2101 Homestead Hills Drive, Winston Salem, NC 27103 2017-09-05
1588186969 Brandy Wilson Social Worker 153 Cameron Way Circle, Winston Salem, NC 27103 2017-07-07
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Taxonomy Information

Taxonomy Code 174H00000X
Grouping Other Service Providers
Classification Health Educator

Taxonomy Definition

Health educators work in a variety of settings providing education to individuals or groups of individuals on healthy behaviors, wellness, and health-related topics with the goal of preventing diseases and health problems. Health educators generally require a bachelor’s degree and may receive additional training, such as through mentoring, internships, or volunteer work.
Notes: Source: National Uniform Claim Committee, 2009 [7/1/2009: definition added]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1902413875 Ymca of Southeastern Nc Health Educator 2710 Market Street, Wilmington, NC 28403 2020-09-25
1891311734 Sharon Rena Jackson Health Educator 4504 Lady Rita Ln, Raleigh, NC 27610-8715 2020-06-16
1982226916 Marie K Mcclellan Health Educator 401 Oldtowne St, Jacksonville, NC 28546-8066 2020-05-13
1598390270 The Nurtured Nest Health Educator 5205 Lake Edge Dr, Holly Springs, NC 27540-9182 2020-03-03
1366074981 C Delane Jones Health Educator 4316 Hubbard Rd, Charlotte, NC 28269-2375 2020-02-11
1669002010 Lisa Yvette Johnson Health Educator 4939 Pleasant Grove Dr, Wilmington, NC 28412-2288 2020-01-23
1649811779 Brittany Madison Waters Health Educator 5707 Cougar Ln, Charlotte, NC 28269-1514 2019-09-30
1770133712 Lucille Gillard Health Educator 464 White Oak Ln, Midway Park, NC 28544-1239 2019-09-11
1629542287 Made Well Center for Wholeness, LLC Health Educator 4914 Grouse Woods Dr, Wilmington, NC 28411-6538 2019-01-17
1063983286 Ivan Ortega Health Educator 810 Fairgrove Church Road Se, Hickory, NC 28602 2018-12-16
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Competitor

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City WINSTON SALEM
Zip Code 27103

Improve Information

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Dataset Information

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.

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