Individual provider Active NPI

Kaitlyn Cockerham Stefanick, PA-C

  • Surgical Physician Assistant
  • Durham, NC
National Provider Identifier
1174147102
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0010-09836 Issued in NC
Practice address
3643 N Roxboro St
Durham, NC 27704-2702
Phone
(919) 470-4000
NPI assigned
Jun 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0010-09836 NC Primary

Addresses

Primary practice location

3643 N Roxboro St
Durham, NC 27704-2702

Mailing address

622 E Whitaker Mill Rd
Raleigh, NC 27608-2636
Phone (336) 407-3633

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
I20201217002143 NC Practitioner - Physician Assistant 2466864350 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of North Carolina at Chapel Hill School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke University Health System, IncGroup PAC ID 2567372345, 1,083 clinicians

Practice addresses (Care Compare)

2301 Erwin Rd
Durham, NC 27705-4699
Phone (919) 684-8111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-09836NCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Health System, Inc. CurrentSince Dec 30, 2025 Accepting new patients
Duke University Health System, Inc. CurrentSince Dec 30, 2025 Accepting new patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Duke University Health System, Inc. Past Accepting new patients

Locations

1234 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-1234

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

407 Crutchfield St
Durham, NC 27704
Phone (919) 470-6516

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

1352 Mebane Oaks Rd
Mebane, NC 27302
Phone (919) 525-3632

3480 Wake Forest Rd
Ste 502
Raleigh, NC 27609
Phone (919) 420-5000

Interoperability endpoints

  • Direct secure messaging: kcockerham469513@direct.medicine.duke.edu

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 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": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1174147102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 E WHITAKER MILL RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276082636",
            "telephone_number": "336-407-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3643 N ROXBORO ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042702",
            "telephone_number": "919-470-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFANICK",
        "first_name": "KAITLYN",
        "middle_name": "COCKERHAM",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-09836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.