Active NPI
John C Kish, PA
- Physician Assistant
- Clyde, NC
National Provider Identifier
1013910843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 103183
- Practice address
- 35 Facility Drive
Medwest
Clyde, NC 28721 - Phone
- (828) 452-5042
- Fax
- (828) 452-9225
- NPI assigned
- May 24, 2005
- Last updated
- Apr 19, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 103183 | NC | Primary |
Addresses
Primary practice location
35 Facility Drive
Medwest
Clyde, NC 28721
Mailing address
35 Facility Dr
Clyde, NC 28721-9438
Phone (828) 452-8110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103183 | NC | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clyde Emergency Solutions LLC | Past | Accepting new patients | |
| Phoenix Emergency Solutions of Fletcher PLLC | Past | Accepting new patients | |
| DLP Haywood Regional Medical Center LLC. | Past | Accepting new patients | |
| Hendersonville Emergency Consultants PC | Past | Accepting new patients |
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Statesville, NC
- NPI 1396216735
-
- Emergency Medicine Physician
- Clyde, NC
- NPI 1417015066
-
dba Haywood Regional Medical Center
- General Acute Care Hospital
- Clyde, NC
- NPI 1811158215
-
- Emergency Medicine Physician
- Hendersonville, NC
- NPI 1942203088
-
- Emergency Medicine Physician
- Hendersonville, NC
- NPI 1689726275
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492560000000",
"number": "1013910843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 FACILITY DR",
"city": "CLYDE",
"state": "NC",
"postal_code": "287219438",
"telephone_number": "828-452-8110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 FACILITY DRIVE",
"address_2": "MEDWEST",
"city": "CLYDE",
"state": "NC",
"postal_code": "28721",
"telephone_number": "828-452-5042",
"fax_number": "828-452-9225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISH",
"first_name": "JOHN",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-24",
"last_updated": "2017-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "103183",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clyde, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.