Individual provider Active NPI

Kaitlin Frankie Hoover Williamson, PA-C

  • Physician Assistant
  • Lexington, NC
National Provider Identifier
1063862399
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-06550 Issued in NC
Practice address
110 W Medical Park Dr
Lexington, NC 27292-6773
Phone
(336) 248-8692
Fax
(336) 249-7348
NPI assigned
Jun 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X 0010-06550 NC Primary

Addresses

Primary practice location

110 W Medical Park Dr
Lexington, NC 27292-6773

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other names 1

  • Kaitlin Elizabeth Frankie Hoover Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address khoover334070@direct.novanthealth.org

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
I20160912000256 NC Practitioner - Physician Assistant 1658667027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

108 W Medical Park Dr
Lexington, NC 27292-6773
Phone (336) 243-7054

110 W Medical Park Dr
Lexington, NC 27292-6773
Phone (336) 248-8692

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

5145 Sellers Rd
Shallotte, NC 28470-3405
Phone (910) 754-4572

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-06550NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Jul 19, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 19, 2023 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

110 W Medical Park Dr
Lexington, NC 27292
Phone (336) 248-8692

4705 S Highway 150
Ste Bc
Lexington, NC 27295
Phone (336) 481-1780

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

175 Kimel Park Dr
Ste 100
Winston Salem, NC 27103
Phone (336) 277-1811

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 3

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": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1063862399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W MEDICAL PARK DR",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272926773",
            "telephone_number": "336-248-8692",
            "fax_number": "336-249-7348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "KAITLIN",
        "middle_name": "FRANKIE HOOVER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-17",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khoover334070@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "110 W Medical Park Dr",
            "city": "Lexington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272926773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "HOOVER",
            "middle_name": "ELIZABETH FRANKIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lexington, NC

Sources for this page

Verify at the official NPI Registry.