Individual provider Active NPI

Kelby Lewis Harrup, PA-C

  • Physician Assistant
  • Ahoskie, NC
National Provider Identifier
1154161669
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
120 Health Center Dr
Ahoskie, NC 27910-8161
Phone
(252) 332-3548
NPI assigned
May 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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 Primary

Addresses

Primary practice location

120 Health Center Dr
Ahoskie, NC 27910-8161

Mailing address

15617 Pinopolis Rd
Boykins, VA 23827-2043
Phone (757) 653-1412

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
I20250429002196 NC Practitioner - Physician Assistant 6709302110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

120 Health Ctr Dr
Ahoskie, NC 27910-8161
Phone (252) 332-3548

305 Beechwood Blvd
Murfreesboro, NC 27855-1134
Phone (252) 398-3323

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Roanoke Chowan Community Health Center Inc CurrentSince Feb 17, 2025 Accepting new patients
Roanoke Chowan Community Health Center Inc CurrentSince Feb 17, 2025 Accepting new patients

Locations

120 Health Center Dr
Ahoskie, NC 27910
Phone (252) 209-0237

113 Hertford County High Rd
#B
Ahoskie, NC 27910
Phone (252) 209-3375

305 Beechwood Blvd
Murfreesboro, NC 27855
Phone (252) 398-3323

Organizations & group practices 2

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 2

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": "1717113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1154161669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15617 PINOPOLIS RD",
            "city": "BOYKINS",
            "state": "VA",
            "postal_code": "238272043",
            "telephone_number": "757-653-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HEALTH CENTER DR",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279108161",
            "telephone_number": "252-332-3548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRUP",
        "first_name": "KELBY",
        "middle_name": "LEWIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ahoskie, NC

Sources for this page

Verify at the official NPI Registry.