Individual provider Active NPI

Kelsey Ann Kramer, PA

  • Physician Assistant
  • Bolivia, NC
National Provider Identifier
1083389464
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001011358 Issued in NC
Practice address
240 Hospital Dr NE
Bolivia, NC 28422-8346
Phone
(910) 921-2070
Fax
(910) 721-2074
NPI assigned
Aug 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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 001011358 NC Primary

Addresses

Primary practice location

240 Hospital Dr NE
Bolivia, NC 28422-8346

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (910) 721-2070

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kkramer326108@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, AK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210909002027 NC Practitioner - Physician Assistant 2062818404 Reassigns benefits to 3 organizations
I20241007001584 AK Practitioner - Physician Assistant 2062818404 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wake Forest University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Camai Community Health Center IncGroup PAC ID 3476690876, 12 clinicians

Practice addresses (Care Compare)

2 School Rd
Naknek, AK 99633-0211
Phone (907) 246-6155

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001011358NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Sep 1, 2021 Accepting new patients
Novant Medical Group Inc CurrentSince Sep 1, 2021 Accepting new patients
Norton Sound Health Corporation CurrentSince Nov 12, 2024 Accepting new patients
Norton Sound Health Corporation Physician Assistant CurrentSince Nov 12, 2024 Accepting new patients
Alaska Imaging Associates, LLC Past Accepting new patients

Locations

240 Hospital Dr NE
Bolivia, NC 28422
Phone (336) 399-7678

200 Hospital Ave
Jefferson, NC 28640
Phone (336) 246-7101

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

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

Interoperability endpoints

  • Direct secure messaging: kelsey.kramer.1@20726.direct.athenahealth.com

Organizations & group practices 9

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1083389464",
    "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",
            "telephone_number": "910-721-2070",
            "fax_number": "910-721-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 HOSPITAL DR NE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228346",
            "telephone_number": "910-921-2070",
            "fax_number": "910-721-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAMER",
        "first_name": "KELSEY",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001011358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkramer326108@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "240 Hospital Dr NE",
            "city": "Bolivia",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284228346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bolivia, NC

Sources for this page

Verify at the official NPI Registry.