Kerry Agnello, D.O.
Individual provider Active NPI Family Medicine Physician · Fort Bragg, NC
NPI 1063483774 · NPPES record last updated Dec 3, 2025
Key facts
- NPI
- 1063483774
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2011-01723 (NC)
- Practice address
- 2817 Rock Merritt Ave
Fort Bragg, NC 28310-0001 - Phone
- (910) 907-8922
- Fax
- (910) 907-6069
- NPI assigned
- Jan 30, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2011-01723 | NC | MD | Family Medicine Physician |
| 25MB07942900 | NJ | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Luke'S Warren Hospital, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2011-01723 | NC | Yes |
| Family Medicine Physician | 207Q00000X | 25MB07942900 | NJ |
Addresses
Primary practice location
2817 Rock Merritt Ave
Fort Bragg, NC 28310-0001
Mailing address
2817 Rock Merritt Ave
Fort Bragg, NC 28310-0001
Phone (910) 907-8922
Other providers in Fort Bragg, NC
- Sheila R Adams
- Vanessa Adderty
- Adeoye Adebote
- Ebenezer Adeniran
- Dylan Edwin Agans
- Alini Agnes
- Doreene Roxanne Aguayo
- Caroline B. Ahlers-Burge
- Justina Jean Ahn
- Jasmine Akalaonu
All providers in Fort Bragg, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.