KELLIE NEWSOME (NPI# 1649718180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649718180 |
| Entity Type | Individual |
| Full Name | KELLIE NEWSOME |
| Practice Address |
1615 Polo Rd Winston Salem NC 27106-3831 |
| Mailing Address |
713 S Marshall St Winston Salem NC 27101-5808 |
| Practice Telephone | 3367227266 |
| Practice Fax Number | 3362010538 |
| Mailing Telephone | 3367227266 |
| Mailing Fax Number | 3362010538 |
| Enumeration Date | 2017-02-04 |
| Last Update Date | 2020-01-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WC1500X |
Registered Nurse Specialization: Community Health |
1967917 | NC | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
5012740 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1901 Adams Farm Pkwy, Greensboro, NC 274076338 | 3367227266 | 3362010538 |
| 2128 Violet St, Winston Salem, NC 271272948 | 3362870252 | |
| 2235 Lewisville Clemmons Rd Ste A, Clemmons, NC 270129342 | 3367227266 | 3362010538 |
| Street Address |
1615 POLO RD |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27106-3831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427034768 | Christopher Bruns Aiken | Psychiatry & Neurology | 1615 Polo Rd, Winston Salem, NC 27106-3859 | 2005-12-19 |
| 1386206654 | Tina Long Spach | Social Worker | 1615 Polo Rd, Winston Salem, NC 27106-3831 | 2019-07-08 |
| 1588159834 | Esther Simone Suess | Counselor | 1615 Polo Rd, Winston Salem, NC 27106-3831 | 2018-06-28 |
| 1336632009 | Bethany Godwin | Counselor | 1615 Polo Rd, Winston Salem, NC 27106-3831 | 2018-06-07 |
| 1740782507 | Rebecca Stevens | Counselor | 1615 Polo Rd, Winston Salem, NC 27106-3831 | 2018-03-07 |
| 1417495458 | Lindsay Reynolds | Social Worker | 1615 Polo Rd, Winston Salem, NC 27106-3831 | 2017-02-10 |
| 1598213993 | Kelly Welch Joyce | Counselor | 1615 Polo Rd, Winston Salem, NC 27106-3831 | 2016-09-14 |
| 1053798694 | Valerie Vestal | Nurse Practitioner | 1615 Polo Rd, Winston Salem, NC 27106-3831 | 2015-05-04 |
| 1437568334 | Jill Elyse Gaukstern | Counselor | 1615 Polo Rd, Winston Salem, NC 27106-3831 | 2014-08-05 |
| 1053737148 | Anna Leisa Sauser | Counselor | 1615 Polo Rd, Winston Salem, NC 27106-3831 | 2014-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437799103 | Tyler Laura Lawrence | Behavioral Analyst | 1959 N Peace, 104, Winston-salem, NC 27106 | 2020-01-10 |
| 1316504624 | Amanda Baker | Behavior Technician | 1959 N Peace Haven Rd, Suite 104, Winston Salem, NC 27106 | 2019-05-22 |
| 1679030316 | Lavonda Williams | Behavior Technician | 1959 N Peace Haven Road, Winston Salem, NC 27106 | 2019-03-01 |
| 1518436708 | Angela Ruth Brown | Physical Therapy Assistant | 190 Moravian Way Drive, Winston-salem, NC 27106 | 2018-11-16 |
| 1407378896 | Applied Family Services of Winston-salem | Early Intervention Provider Agency | 4220 Witherow Rd, Winston Salem, NC 27106 | 2017-07-07 |
| 1750801676 | Julia Ann Horton | Speech-Language Pathologist | 2000 Salemtowne Drive, Winston Salem, NC 27106 | 2017-06-21 |
| 1124548037 | Tyler John Jones | Community Health Worker | 7014 Brandemere Ln. Apt F, Winston Salem, NC 27106 | 2017-06-21 |
| 1396274759 | Jennifer Cui | Social Worker | 3216 Cross Tree Rd, Winston-salem, NC 27106 | 2017-06-08 |
| 1063947802 | Rebecca Jeanette Mclemore | Social Worker | 4401 Providence Ln. #121, Top Priority Care Services, LLC., Winston-salem, NC 27106 | 2017-05-01 |
| 1720529357 | Rising Hope Clinical Assistance, LLC | Community/Behavioral Health | 510 Northgate Park Dr, Winston Salem, NC 27106 | 2017-03-15 |
| Find all providers in zip 27106 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184249393 | Adaku Anike | Nurse Practitioner | 1 Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-06-12 |
| 1043869746 | Lisa Maria Waye | Nurse Practitioner | 3637 Old Vineyard Rd, Winston Salem, NC 27104-4842 | 2019-09-05 |
| 1487015376 | Stefanie T Livingston | Nurse Practitioner | 380 Knollwood St # 505, Winston Salem, NC 27103-1884 | 2016-03-19 |
| 1053798694 | Valerie Vestal | Nurse Practitioner | 1615 Polo Rd, Winston Salem, NC 27106-3831 | 2015-05-04 |
| 1437498326 | Marjorie G Sales | Nurse Practitioner | 3000 Bethesda Pl, Suite 801, Winston Salem, NC 27103-3331 | 2013-02-12 |
| 1639436124 | Carolyn D Orr | Nurse Practitioner | 1615 Polo Rd, Winston Salem, NC 27106-3831 | 2012-04-20 |
| 1851454649 | Victoria Marie Soltis-jarrett | Nurse Practitioner | 1365 Westgate Center Dr, Winston Salem, NC 27103-2980 | 2006-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730078 | Leetisha Lawana Dunia | Nurse Practitioner | 538 Wood Point Dr, Lillington, NC 27546-5971 | 2020-11-06 |
| 1881292134 | Jurell Kirice Riley | Nurse Practitioner | 6301 Dumont Ln, Charlotte, NC 28269-6147 | 2020-10-09 |
| 1336756899 | Jennifer Danks | Nurse Practitioner | 1845 Keener Rd, Clinton, NC 28328-8039 | 2020-09-29 |
| 1376159400 | Ronald Jerome Patterson Jr. | Nurse Practitioner | 4204 Banks Stone Dr, Raleigh, NC 27603-4860 | 2020-09-23 |
| 1902411499 | Solari Mental and Behavioral Health Services | Nurse Practitioner | 11206 Highcrest Dr, Huntersville, NC 28078-0610 | 2020-09-10 |
| 1699389684 | Lasting Hope - Mental Health & Recovery | Nurse Practitioner | 131 Fiddlers Run Blvd, Morganton, NC 28655-0095 | 2020-09-07 |
| 1588277727 | Alison Stroh | Nurse Practitioner | 1313 Banyon Grove Loop, Cary, NC 27513-3936 | 2020-08-27 |
| 1902417488 | Erin Klender Pllc | Nurse Practitioner | 12106 Willingdon Rd, Huntersville, NC 28078-5520 | 2020-08-10 |
| 1407466824 | Theresa Uju Ofoemezie | Nurse Practitioner | 250 S San Agustin Dr, Mooresville, NC 28117-8581 | 2020-08-01 |
| 1669090213 | Rashonda R. Wheeler | Nurse Practitioner | 8949 Cinnabay Dr, Charlotte, NC 28216-2189 | 2020-07-10 |
| Find all providers with the same taxonomy | ||||
| City | WINSTON SALEM |
| Zip Code | 27106 |
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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.