MRS. KELLY T BLOUNT (NPI# 1972508828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972508828 |
| Entity Type | Individual |
| Full Name | MRS. KELLY T BLOUNT |
| Credential | PA-C |
| Practice Address |
5603 Duraleigh Rd Suite 111 Raleigh NC 27612-2688 |
| Practice Telephone | 9197910840 |
| Practice Fax Number | 9197910911 |
| Mailing Telephone | 9197910840 |
| Mailing Fax Number | 9197910911 |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2014-02-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
103450 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194194290 | Kelly Blount | Physician Assistant | 3515 Richland Ave, Aiken, SC 29801-6311 | 2015-09-18 |
| 1740211697 | Kelly A Blount | Optometrist | 429 S 3rd St, Gadsden, AL 35901-5210 | 2006-07-06 |
| Street Address |
5603 DURALEIGH RD SUITE 111 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27612-2688 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689678336 | Matthew K Flynn | Specialist | 5603 Duraleigh Rd, Ste 111, Raleigh, NC 27612-2688 | 2005-06-10 |
| 1548529001 | Kara Mariko Brooks | Dermatology | 5603 Duraleigh Rd, Suite 111, Raleigh, NC 27612-2688 | 2012-05-03 |
| 1578743597 | Jerry S. Alvis, D.d.s., P.a. | Exclusive Provider Organization | 5603 Duraleigh Rd, Suite 131, Raleigh, NC 27612-2688 | 2007-11-07 |
| 1558473132 | Elizabeth Marie Macpherson | Nurse Practitioner | 5603 Duraleigh Rd, Suite111, Raleigh, NC 27612-2688 | 2006-08-31 |
| 1912018375 | Ronald B Bean | Physician Assistant | 5603 Duraleigh Rd, Suite 111, Raleigh, NC 27612-2688 | 2006-08-31 |
| 1588674568 | Flynn Dermatology Pa | Specialist | 5603 Duraleigh Rd, Suite 111, Raleigh, NC 27612-2688 | 2006-08-09 |
| 1497790596 | Jerry Shumate Alvis | Dentist | 5603 Duraleigh Rd, Suite 131, Raleigh, NC 27612-2688 | 2006-06-20 |
| 1528029972 | Ginger Elizabeth Smith | Physician Assistant | 5603 Duraleigh Rd, Suite 111, Raleigh, NC 27612-2688 | 2006-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538714068 | George J Henderon | Orthotist | 5313 Duraleigh Road, Ste 151, Raleigh, NC 27612 | 2019-08-01 |
| 1902399223 | Iain Knox Nathaniel Irwin | Marriage & Family Therapist | 7701 Alborz Dr, Raleigh, NC 27612 | 2018-06-12 |
| 1225525884 | Patterns Behavioral Services North Carolina, Inc | Assistant Behavior Analyst | 3738 National Dr, Ste 110, Raleigh, NC 27612 | 2018-04-19 |
| 1053820720 | The Art Counseling L.L.C. | Psychologist | 4610 Twisted Oaks Drive Apt 1807, Raleigh, NC 27612 | 2017-09-26 |
| 1376052431 | Amanda Steed | Speech-Language Pathologist | 5519 Hamstead Crossing, Raleigh, NC 27612 | 2017-09-21 |
| 1295250991 | Neal H. Patel Dds Pllc | Dentist | 7211 Shellburne Dr, Raleigh, NC 27612 | 2017-08-03 |
| 1811426109 | Marquita Randolph-breeden | Behavior Technician | 5816 Creedmoor Road, Suite 104, Raleigh, NC 27612 | 2017-06-08 |
| 1336518554 | Travis Edward Williams | Counselor | 4801 Glenwood Ave., Suite 200, Raleigh, NC 27612 | 2015-09-17 |
| 1831587476 | Harris Teeter LLC | Pharmacy | 2051 W Millbrook Road, Raleigh, NC 27612 | 2015-01-06 |
| 1780072975 | Harris Teeter LLC | Pharmacy | 2051 W. Millbrook Road, Raleigh, NC 27612 | 2014-12-23 |
| Find all providers in zip 27612 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285195768 | Rebecca Lee Hill | Physician Assistant | 3100 Blue Ridge Rd Ste 103, Raleigh, NC 27612-8002 | 2019-03-27 |
| 1306300520 | Lanlen Luke Venable | Physician Assistant | 4414 Lake Boone Trl Ste 502, Raleigh, NC 27607-7521 | 2019-01-23 |
| 1942723788 | Elizabeth Grace Carmen Lee Macarthur | Physician Assistant | 10211 Alm St Ste 1200, Raleigh, NC 27617-8221 | 2017-07-24 |
| 1164969168 | Grace Klinic, LLC | Physician Assistant | 6516 Falls of Neuse Rd, 110, Raleigh, NC 27615-6847 | 2017-01-27 |
| 1982075073 | David Zuckerman | Physician Assistant | 1311 E Millbrook Rd Ofc, Raleigh, NC 27609-5473 | 2015-10-14 |
| 1649570060 | Jeffrey M Rosowski | Physician Assistant | 3320 Executive Dr Ste 222, Raleigh, NC 27609-7445 | 2010-11-02 |
| 1023332020 | Brooke Register Lilley | Physician Assistant | 6500 Creedmoor Rd., Raleigh, NC 27613 | 2010-03-18 |
| 1548582620 | Melanie Fox Langston | Physician Assistant | 7870 Alexander Promenade Pl, Raleigh, NC 27617-7350 | 2010-02-17 |
| 1184863086 | Lisa Marie Hill | Physician Assistant | 2709 Blue Ridge Rd Ste 320, Raleigh, NC 27607-6462 | 2009-02-17 |
| 1538248125 | Harry David Kurtz | Physician Assistant | 4509 Creedmoor Rd Ste 201, Raleigh, NC 27612-3813 | 2006-11-03 |
| Find all providers in RALEIGH | ||||
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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.