Individual provider Active NPI

Kelly Jo Paxton, FNP

  • Family Nurse Practitioner
  • Dallas, NC
National Provider Identifier
1023445087
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5019212 Issued in NC
Practice address
600 W Trade St Ste a
Dallas, NC 28034-1543
Phone
(980) 934-9130
NPI assigned
Oct 3, 2013
Last updated
Jan 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 44489 WV
Family Nurse Practitioner 363LF0000X 5019212 NC Primary

Addresses

Primary practice location

600 W Trade St Ste a
Dallas, NC 28034-1543

Mailing address

600 W Trade St Ste a
Dallas, NC 28034-1543
Phone (980) 834-9130

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
I20240402000227 NC Practitioner - Nurse Practitioner 0345562377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

600 W Trade St
Suite a
Dallas, NC 28034-1543
Phone (704) 834-2450

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group, Inc. CurrentSince Feb 6, 2024 Accepting new patients
Caromont Medical Group Inc Current Accepting new patients
Caromont Medical Group Inc CurrentSince Feb 6, 2024 Accepting new patients

Locations

600 W Trade St
Ste A
Dallas, NC 28034
Phone (980) 834-9130

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

936 Cox Rd
Gastonia, NC 28054
Phone (704) 671-5343

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, 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": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1023445087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W TRADE ST STE A",
            "city": "DALLAS",
            "state": "NC",
            "postal_code": "280341543",
            "telephone_number": "980-834-9130",
            "fax_number": "980-834-9869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W TRADE ST STE A",
            "city": "DALLAS",
            "state": "NC",
            "postal_code": "280341543",
            "telephone_number": "980-934-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAXTON",
        "first_name": "KELLY",
        "middle_name": "JO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-03",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "44489",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5019212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, NC

Sources for this page

Verify at the official NPI Registry.