Healthcare Provider Details

I. General information

NPI: 1568397347
Provider Name (Legal Business Name): JOHN KENSINGER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 SILAS CREEK PKWY
WINSTON SALEM NC
27103-3013
US

IV. Provider business mailing address

300 W END BLVD
WINSTON SALEM NC
27101-1225
US

V. Phone/Fax

Practice location:
  • Phone: 336-718-5000
  • Fax:
Mailing address:
  • Phone: 310-413-5599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: