NPIMap

Organization Active NPI

Generations Family Practice, PA

Doing business as Kernersville Primary Care

  • Family Medicine Physician
  • Kernersville, NC
National Provider Identifier
1003558461
Registry record updated Oct 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GENERATIONS FAMILY PRACTICE, PA
Doing business as
Kernersville Primary Care
Practice address
420 W Mountain St
Kernersville, NC 27284-2534
Phone
(336) 993-1618
Fax
(336) 993-5512
NPI assigned
Apr 7, 2022
Last updated
Oct 23, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
GENERATIONS FAMILY PRACTICE, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kathryn O'Neill
Title
Provider Credentialing Specialist
Phone
(919) 439-8108

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

420 W Mountain St
Kernersville, NC 27284-2534

Mailing address

5000 Centre Green Way Ste 340
Cary, NC 27513-5817
Phone (336) 993-1618

Other names 1

  • Kernersville Primary Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060425000762 NC Part B Supplier - Clinic/Group Practice 7517977200 Receives reassigned benefits from 76 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Asheboro, NC; Carrboro, NC; Cary, NC; Greensboro, NC; Kernersville, NC; Rocky Mount, NC; Wendell, NC

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Generations Family Practice PA3 organizations share this tax ID, including this one
Part of
Generations Family Practice PA

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

138 Dublin Square Rd
Asheboro, NC 27203
Phone (336) 510-1800

804 English Rd
Ste 100
Rocky Mount, NC 27804
Phone (252) 443-3133

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7942/brand/1/csg/1/fhir/r4

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792713600000",
    "number": "1003558461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 CENTRE GREEN WAY STE 340",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275135817",
            "telephone_number": "336-993-1618",
            "fax_number": "336-993-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W MOUNTAIN ST",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842534",
            "telephone_number": "336-993-1618",
            "fax_number": "336-993-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERATIONS FAMILY PRACTICE, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENERATIONS FAMILY PRACTICE, PA",
        "enumeration_date": "2022-04-07",
        "last_updated": "2026-10-23",
        "certification_date": "2026-10-23",
        "status": "A",
        "authorized_official_last_name": "O'NEILL",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "PROVIDER CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "919-439-8108"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kernersville Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kernersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.