Individual provider Active NPI

Kelly Weeks Meads, PA-C

  • Medical Physician Assistant
  • Elizabeth City, NC
National Provider Identifier
1013907765
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
103831 Issued in NC
Practice address
1144 N Road St Ste 200
Elizabeth City, NC 27909-3473
Phone
(252) 384-2360
Fax
(252) 384-2359
NPI assigned
Oct 25, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 103831 NC Primary

Addresses

Primary practice location

1144 N Road St Ste 200
Elizabeth City, NC 27909-3473

Mailing address

1144 N Road St Ste 200
Elizabeth City, NC 27909-3473
Phone (252) 384-2360

Other practice location 1

701 Luke St
Suite C
Edenton, NC 27932-9643
Phone (252) 482-5011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041012001408 NC Practitioner - Physician Assistant 9436119625 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Elizabeth City, NC 27909
Phone (252) 334-0402

1144 N Rd St
Elizabeth City, NC 27909-3473
Phone (252) 384-4804

905 Thunder Rd
Elizabeth City, NC 27909-7672

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
103831NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Aug 19, 2018 Accepting new patients
Albemarle Physician Services - Sentara, Inc CurrentSince Apr 12, 2021 Accepting new patients
Albemarle Physician Services- Sentara, Inc. CurrentSince Apr 12, 2021 Accepting new patients

Locations

211 Virginia Rd
Edenton, NC 27932
Phone (252) 384-2590

701 Luke St
Ste C
Edenton, NC 27932
Phone (252) 482-5011

905 Thunder Rd
Ste 210
Elizabeth City, NC 27909
Phone (252) 334-0460

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

Interoperability endpoints

  • Direct secure messaging: kmeads290657@direct.sentara.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1013907765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 N ROAD ST STE 200",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093473",
            "telephone_number": "252-384-2360",
            "fax_number": "252-384-2359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 N ROAD ST STE 200",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093473",
            "telephone_number": "252-384-2360",
            "fax_number": "252-384-2359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Luke St",
            "address_2": "SUITE C",
            "address_purpose": "LOCATION",
            "city": "Edenton",
            "state": "NC",
            "postal_code": "279329643",
            "country_code": "US",
            "telephone_number": "252-482-5011",
            "fax_number": "252-482-0390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEADS",
        "first_name": "KELLY",
        "middle_name": "WEEKS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-25",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "103831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth City, NC

Sources for this page

Verify at the official NPI Registry.