Kevin Bruce George, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

103761 Issued in NC

Practice address

1917 W Park Dr
North Wilkesboro, NC 28659-3585

Phone

(336) 903-7845

Fax

(336) 903-7841

NPI assigned

Nov 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Appalachian Regional Medical Associates, Inc.

  dba Appalachian Gastroenterology

  • Family Medicine Physician
  • Boone, NC
  • NPI 1669533923
  Medicare reassignment
• Stanly Medical Services, Inc.

  • Family Medicine Physician
  • Albemarle, NC
  • NPI 1144491770
  NPD (past)
• Charles Cole Memorial Hospital

  dba Champion Orthopedics & Sports Medicine

  • Orthopaedic Surgery Physician
  • Olean, NY
  • NPI 1932382058
  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1104808674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 W PARK DR",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593585",
            "telephone_number": "336-903-7845",
            "fax_number": "336-903-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 W PARK DR",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593585",
            "telephone_number": "336-903-7845",
            "fax_number": "336-903-7841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "KEVIN",
        "middle_name": "BRUCE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "010847",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA052674",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fiona Gant
• Gillian Ainsley Gardiner, MD
• John Andrew Garner, LPC-A
• Joe Gates, PA
• Taylor Danielle Gentry
• Kyra Bree Gibbs
• Jessica Gilley, LCMHCA
• Kimberly Sue Gilreath, CADC
• Mark James Glanzer, D.C.
• Whitney Allen Goering, M.D.

• Physician Assistant in North Wilkesboro, NC
• Providers in North Wilkesboro, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.