MR. KYLE JUDSON KENYON (NPI# 1417341405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417341405 |
| Entity Type | Individual |
| Full Name | MR. KYLE JUDSON KENYON |
| Credential | PA-C |
| Practice Address |
197 Plaza Dr The Clinic At Walmart Forest City NC 28043-3712 |
| Mailing Address |
288 S Ridgecrest Ave Dlp Rutherford Physician Practices, LLC Rutherfordton NC 28139-2838 |
| Practice Telephone | 8282869438 |
| Mailing Telephone | 8282865572 |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2015-03-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0010-05653 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588126502 | Kyle Kenyon | Student in an Organized Health Care Education/Training Program | 625 Elmwood Ave # 683, Rochester, NY 14620-2913 | 2019-04-01 |
| Street Address |
197 PLAZA DR THE CLINIC AT WALMART |
| City | FOREST CITY |
| State | NC |
| Zip Code | 28043-3712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275580490 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 197 Plaza Dr, Forest City, NC 28043-3712 | 2006-05-31 |
| 1184108003 | Curtis Koone | Pharmacist | 197 Plaza Dr, Forest City, NC 28043-3712 | 2018-09-17 |
| 1447668793 | Brian Christopher Robbins | Pharmacist | 197 Plaza Dr, Forest City, NC 28043-3712 | 2014-07-31 |
| 1427465491 | Tonya Taylor | Pharmacist | 197 Plaza Dr, Forest City, NC 28043-3712 | 2014-07-22 |
| 1699182600 | Sean Russel Ott | Pharmacist | 197 Plaza Dr, Forest City, NC 28043-3712 | 2014-07-22 |
| 1912314915 | Krista Debrew | Pharmacist | 197 Plaza Dr, Forest City, NC 28043-3712 | 2014-07-22 |
| 1972845204 | Alan D Ancillotti | Nurse Practitioner | 197 Plaza Dr, Forest City, NC 28043-3712 | 2013-03-25 |
| 1679858914 | Rutherford Hospital Inc | Nurse Practitioner | 197 Plaza Dr, Forest City, NC 28043-3712 | 2011-10-19 |
| 1255358495 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 197 Plaza Dr, Forest City, NC 28043-3712 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528475530 | Lori Hammond West | Pharmacist | 139 East Main St, Forest City, NC 28043 | 2014-07-22 |
| 1982989943 | Hope Care Center, Inc. | Assisted Living Facility | 136 Yelton's Circle, Forest City, NC 28043 | 2011-10-20 |
| 1770804643 | Brandi R Holtsclaw | Physical Therapist | 2270 Us Hwy 74a Suite 341, Onesource Rehab, Forest City, NC 28043 | 2010-06-15 |
| 1093944217 | New Start of The Piedmont Inc. | Community/Behavioral Health | 331 South. Broadway Street., Forest City, NC 28043 | 2009-07-09 |
| 1568690493 | Directcare Community Based Services, LLC | Community/Behavioral Health | 129 First Street, Forest City, NC 28043 | 2009-06-30 |
| 1760663058 | Americare Developmental Services | Residential Treatment Facility, Emotionally Disturbed Children | 313 Harrill Rd, Forest City, NC 28043 | 2007-11-15 |
| 1255529038 | Respiratory At Home Plus, Corp. | Durable Medical Equipment & Medical Supplies | 338 Withrow Road, Suite D, Forest City, NC 28043 | 2007-10-05 |
| 1821129362 | K D Support Services / Kelly's Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 158 Us Highway 221a, Forest City, NC 28043 | 2007-03-08 |
| 1407986714 | Americas Living Centers LLC | Custodial Care Facility | 128 Country Meadows Lane, Forest City, NC 28043 | 2007-03-06 |
| 1821157256 | Hopewell Care Inc. | Assisted Living Facility | 141 Fox Run, Forest City, NC 28043 | 2006-12-08 |
| Find all providers in zip 28043 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104908748 | Paul R. Granzow | Physician Assistant | 181 Daniel Rd, Forest City, NC 28043-7151 | 2006-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902403884 | Billy Scott II | Physician Assistant | 3000 Rogers Rd Ste 100, Wake Forest, NC 27587-5745 | 2020-10-05 |
| 1982213765 | Michaela Lynne Mcbride | Physician Assistant | 9541 Kings Parade Blvd Unit 107, Charlotte, NC 28273-5819 | 2020-07-28 |
| 1386260347 | Elizabeth Warrington Maiche | Physician Assistant | 113 Montgomery Dr, Saluda, NC 28773-7787 | 2020-06-24 |
| 1831715663 | John Wheary | Physician Assistant | 3233 Austin Ave, New Bern, NC 28562-7084 | 2020-06-17 |
| 1629692439 | Julie Anne Augustine | Physician Assistant | 718 S Green St, Winston Salem, NC 27101-5112 | 2020-06-08 |
| 1659995710 | Kristopher Neal Priddy | Physician Assistant | 405 Forest Hill Dr, Shelby, NC 28150-5520 | 2020-06-04 |
| 1710500558 | Christian Wright Fulenwider | Physician Assistant | 104 Linden St, Morganton, NC 28655-3788 | 2020-05-27 |
| 1366065500 | Lisa Lynn Carder | Physician Assistant | 904 Foxcroft Cir Apt D, Shelby, NC 28152-6868 | 2020-05-22 |
| 1982234282 | Brandon Sorkin | Physician Assistant | 280 Executive Park Drive, Suite 100, Concord, NC 28025-2802 | 2020-01-25 |
| 1245860618 | Robert Maughan | Physician Assistant | 129 Bryce Creek Ln, Fayetteville, NC 28303-4981 | 2020-01-24 |
| Find all providers with the same taxonomy | ||||
| City | FOREST CITY |
| Zip Code | 28043 |
Please comment or provide details below to improve the information on MR. KYLE JUDSON KENYON.
| 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.