Rachel Catherine Kellomaki, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-09069 Issued in NC

Practice address

1880 Quiet CV
Fayetteville, NC 28304-3857

Phone

(910) 323-2477

Fax

(910) 323-5931

NPI assigned

Aug 7, 2019

Last updated

Aug 19, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Rachel Catherine Weaver Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1013562982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87388",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283047388",
            "telephone_number": "910-323-2477",
            "fax_number": "910-323-5931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 QUIET CV",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043857",
            "telephone_number": "910-323-2477",
            "fax_number": "910-323-5931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOMAKI",
        "first_name": "RACHEL",
        "middle_name": "CATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rachel-kellomaki@cfcdd-net.e-mdsdirect.com",
            "affiliation": "N",
            "address_1": "1880 Quiet Cv",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283043857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "WEAVER",
            "middle_name": "CATHERINE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tamara Keibler, R.PH.
• Mary Rebecca Keith, DMD
• Valentine Chimaobi Keke, MD
• Rosemary Eileen Kelley, PA-C
• Louise Henri Kelliher, LPC, LMFT
• Lacy Godwin Kells, DPT
• Kelly Counseling Center
• Brittany Kelly, BT
• Catherine Margaret Kelly, M.D.
• Courtney Kelly

• Physician Assistant in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.