Individual provider Active NPI

Keith William Paul, PA-C

  • Physician Assistant
  • Greensboro, NC
National Provider Identifier
1023260833
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-01573 Issued in NC
Practice address
1321 New Garden Rd
Greensboro, NC 27410-2722
Phone
(336) 299-0099
Fax
(336) 299-0080
NPI assigned
Oct 13, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-01573 NC Primary

Addresses

Primary practice location

1321 New Garden Rd
Greensboro, NC 27410-2722

Mailing address

1321 New Garden Rd
Greensboro, NC 27410-2722
Phone (336) 299-0099

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
I20081110000829 NC Practitioner - Physician Assistant 1951460641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Trauma Specialists PCGroup PAC ID 7012007701, 5 clinicians

Practice addresses (Care Compare)

1321 New Garden Rd
Greensboro, NC 27410-2722
Phone (336) 299-0099

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01573NCMDMassage Therapist
0010-01573NCMDPhysician Assistant

Organizations & group practices 1

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.

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": "1223856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1023260833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 NEW GARDEN RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102722",
            "telephone_number": "336-299-0099",
            "fax_number": "336-299-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 NEW GARDEN RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102722",
            "telephone_number": "336-299-0099",
            "fax_number": "336-299-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "KEITH",
        "middle_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-13",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.