Kenneth William Porter Shirley (NPI# 1932104080, PAC ID# 8820080443) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1932104080 |
| PAC ID by PECOS | 8820080443 |
| Professional Enrollment ID | I20040401001465 |
| Full Name | Kenneth William Porter Shirley |
| Organization Legal Name | KERNERSVILLE EMERGENCY GROUP, PLLC |
| Address |
1750 Kernersville Medical Pkwy Kernersville NC 27284-7146 |
| Phone Number | 3365644000 |
| Gender | M |
| Credential | MD |
| Medical School | EAST TENNESSEE STATE UNIVERSITY, QUILLEN-DISHNER COLLEGE OF MEDICINE |
| Graduation Year | 1999 |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 3375885429 |
| Number of Group Practice Members | 25 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 340014 | NOVANT HEALTH FORSYTH MEDICAL CENTER |
| 340085 | NOVANT HEALTH THOMASVILLE MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 6915 Village Medical Cir, Clemmons, NC 27012-8002 | 3368931000 | TANGLEWOOD PARK PHYSICIANS, PLLC |
| 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 | 3365644000 | KERNERSVILLE EMERGENCY GROUP, PLLC |
| 207 Old Lexington Rd, Thomasville, NC 27360-3428 | 3364722000 | PIEDMONT TRIAD PHYSICIANS PLLC |
| Organization Legal Name | KERNERSVILLE EMERGENCY GROUP, PLLC |
| Physicians | 11 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jesse Homer Ellsworth | Emergency Medicine | Kernersville Emergency Group, Pllc | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| Elizabeth M Caudill | Emergency Medicine | Kernersville Emergency Group, Pllc | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| Sean N Fling | Emergency Medicine | Kernersville Emergency Group, Pllc | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| Andrew O Pylant | Emergency Medicine | Kernersville Emergency Group, Pllc | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| Deonza Nicole Thymes | Emergency Medicine | Kernersville Emergency Group, Pllc | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| Catherine Claire Fraley | Emergency Medicine | Kernersville Emergency Group, Pllc | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| Eliot Anthony Atstupenas | Emergency Medicine | Kernersville Emergency Group, Pllc | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| John D Bream | Emergency Medicine | Kernersville Emergency Group, Pllc | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| Aaren M Hunt | Emergency Medicine | Kernersville Emergency Group, Pllc | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| Paul F Mcguire | Emergency Medicine | Kernersville Emergency Group, Pllc | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| Street Address |
1750 KERNERSVILLE MEDICAL PKWY |
| City | KERNERSVILLE |
| State | NC |
| Zip | 27284-7146 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Frances Elizabeth Dechurch | Hospitalist | Novant Medical Group Inc | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| Jesse Homer Ellsworth | Emergency Medicine | Kernersville Emergency Group, Pllc | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| Elizabeth M Caudill | Emergency Medicine | Kernersville Emergency Group, Pllc | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| Sean N Fling | Emergency Medicine | Kernersville Emergency Group, Pllc | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| Kelley A Wallace | Hospitalist | Novant Medical Group Inc | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| Philmo Youngmin Oh | Radiation Oncology | Piedmont Radiation Oncology P A | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| Donald Brescia | Pulmonary Disease | Novant Medical Group Inc | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| Andrew O Pylant | Emergency Medicine | Kernersville Emergency Group, Pllc | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| Michael G Arapian | Internal Medicine | Novant Medical Group Inc | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| Gregory S Robins | Physician Assistant | Novant Medical Group Inc | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William Kelly | Family Medicine | 420 W Mountain St, Kernersville, NC 27284-2534 | |
| Matthew C Mcintyre | Chiropractic | 432 A W Mountain St, Kernersville, NC 27284-2534 | |
| Joann Marie Governale | Clinical Social Worker | 110 Hepler St, Suite B, Kernersville, NC 27284-2793 | |
| Darian J Smith | Chiropractic | 127 N Main St, Kernersville, NC 27284-2815 | |
| Darian L Smith | Chiropractic | 127 N Main St, Kernersville, NC 27284-2815 | |
| Adam D Meylor | Chiropractic | 205 N Cherry St, Kernersville, NC 27284-2825 | |
| Tiffany S Gibson | Nurse Practitioner | Forsyth Memorial Hospital Inc | 291 Broad St, Kernersville, NC 27284-2932 |
| Shauna Jarrett | Nurse Practitioner | Forsyth Memorial Hospital Inc | 291 Broad St, Kernersville, NC 27284-2932 |
| Alexei Radiontchenko | Family Medicine | Forsyth Memorial Hospital Inc | 291 Broad St, Kernersville, NC 27284-2932 |
| Bilal Muzaffar | Rheumatology | Forsyth Memorial Hospital Inc | 291 Broad St, Kernersville, NC 27284-2932 |
| Find all physicians in zip 27284 | |||
| City | KERNERSVILLE |
| Zip Code | 27284 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | KERNERSVILLE + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Kenneth William Porter Shirley.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.