Kelly Ann Payne, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11317 Issued in NC

Practice address

292 Commerce Ave
Southern Pines, NC 28387-7059

Phone

(910) 477-6236

Fax

(910) 477-6357

NPI assigned

Jul 10, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peak Performance Sports and Physical Therapy LLCGroup PAC ID 0749276426, 60 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Peak Performance Sports and Physical Therapy, LLC

  • Physical Therapist
  • New Bern, NC
  • NPI 1194714063
  Medicare reassignment Care Compare group NPD
• Carolina Strong Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Southport, NC
  • NPI 1851783815

  Physical Therapist

  NPD

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1184888943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 COMMERCE AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283877059",
            "telephone_number": "910-477-6236",
            "fax_number": "910-477-6357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 COMMERCE AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283877059",
            "telephone_number": "910-477-6236",
            "fax_number": "910-477-6357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4002 Executive Park Blvd Ste 800",
            "address_purpose": "LOCATION",
            "city": "Southport",
            "state": "NC",
            "postal_code": "284619069",
            "country_code": "US",
            "telephone_number": "910-477-6236",
            "fax_number": "910-477-6357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2021-05-12",
        "certification_date": "2021-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "11317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "P11317",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laneshia Patrick, AGNP-C, PMHNP-BC
• Karen Denise Patterson, DNP, AGPCNP
• Paige Patton, MSW
• Tania Paul, MD
• Denise Maria Pavletic, MPH, RD
• Michael S Payne, DPT
• Jeannine Noble Pearson, PT, DPT
• Vance Alexander Pearson, PTA
• Lauren Peledge, FNP
• Rita Bianco Pena, COTA/L

• Physical Therapist in Southern Pines, NC
• Providers in Southern Pines, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.