Kelly Lee Glisson, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5006909 Issued in NC

Practice address

2421 Silver Stream LN
Wilmington, NC 28401-7684

Phone

(910) 341-3300

Fax

(910) 251-2067

NPI assigned

Jun 26, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Duke University School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• J Arthur Dosher Memorial Hospital Hospital, Southport, NC, CCN 341327

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.glisson.p1@direct.wilmingtonhealth.nextgenshare.com

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.

• Wilmington Health PLLC

  • Multi-Specialty Clinic/Center
  • Wilmington, NC
  • NPI 1881632339
  Medicare reassignment Care Compare group NPD
• Wilmington ASC LLC

  dba Wilmington Health Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Wilmington, NC
  • NPI 1548456478
  NPD
• Wilmington Health PLLC

  • Sleep Specialist (PhD)
  • Wilmington, NC
  • NPI 1043485097
  NPD
• Wilmington Health PLLC

  dba Childrens Clinic

  • Pediatrics Physician
  • Wilmington, NC
  • NPI 1639365562
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• J Arthur Dosher Memorial Hospital

  dba Dosher Wellness Center

  • Rural Health Clinic/Center
  • Southport, NC
  • NPI 1326589649

  Hospital

  Care Compare affiliation
• J. Arthur Dosher Memorial Hospital

  dba Dosher Medical - Oak Island

  • Rural Health Clinic/Center
  • Oak Island, NC
  • NPI 1235405358

  Hospital

  Care Compare affiliation
• J. Arthur Dosher Memorial Hospital

  dba Dosher Medical - Bald Head Island

  • General Practice Physician
  • Bald Head Island, NC
  • NPI 1376961219

  Hospital

  Care Compare affiliation
• J. Arthur Dosher Memorial Hospital

  • Critical Access Hospital
  • Southport, NC
  • NPI 1538260229
  Care Compare affiliation
• J. Arthur Dosher Memorial Hospital

  dba Dosher Medical - Long Beach Road

  • Rural Health Clinic/Center
  • Southport, NC
  • NPI 1568887818

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1144635376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751069",
            "address_2": "ECU PHYSICIANS",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 SILVER STREAM LN",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017684",
            "telephone_number": "910-341-3300",
            "fax_number": "910-251-2067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "517 Moye Blvd",
            "address_2": "ECU Physicians Medicine and Peds Clinic",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278342849",
            "country_code": "US",
            "telephone_number": "252-744-0766",
            "fax_number": "252-744-0392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLISSON",
        "first_name": "KELLY",
        "middle_name": "LEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "229280",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5006909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "188F4",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144635376",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ivey Glendy, AUD
• Adam Daniel Glener, MD
• Glenn W Weckel DC Inc
• Meredith Taylor Edgerton Glenn, D.D.S.
• Scott Jason Glickauf, LAT ATC
• Global Express Transportation Service, LLC
• Susan M Glose, ANP
• Amy Lynn Gnipp, FNP-C
• Go Inward, PLLC
• Go Pharmacy Inc (Go RX)

• Nurse Practitioner in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.