Kelly Graham Wilkins, FNP-C, PMHNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5005394 Issued in NC

Practice address

620 Johns Rd
Laurinburg, NC 28352-5128

Phone

(910) 276-8400

NPI assigned

Oct 31, 2011

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

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

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Breeches Buoy Addiction Medicine ServicesGroup PAC ID 3577962984, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeastern Regional Medical Center Hospital, Lumberton, NC, CCN 340050

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Breeches Buoy Addiction Medicine Services

  • Addiction Medicine (Internal Medicine) Physician
  • Lumberton, NC
  • NPI 1962097626
  Medicare reassignment Care Compare group NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  NC

  Medicare reassignment Care Compare group NPD
• Integrated Behavioral Healthcare Services, PA

  • Psychologist
  • Fayetteville, NC
  • NPI 1689842551
  Medicare reassignment NPD
• Complexcare Medical Group Midwest M PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1528851607

  NC

  Medicare reassignment NPD
• Theoria Medical

  dba Theoria Primary Care

  • Internal Medicine Physician
  • Brighton, MI
  • NPI 1164186946
  NPD (past)

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

• Southeastern Regional Medical Center

  dba UNC Health Southeastern

  • General Acute Care Hospital
  • Lumberton, NC
  • NPI 1427030774
  Care Compare affiliation

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

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1275819617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8465 SHANNON RD",
            "city": "SHANNON",
            "state": "NC",
            "postal_code": "283869333",
            "telephone_number": "910-775-9202",
            "fax_number": "910-775-9224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 JOHNS RD",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283525128",
            "telephone_number": "910-276-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "KELLY",
        "middle_name": "GRAHAM",
        "name_prefix": "Mrs.",
        "credential": "FNP-C, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-31",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5005394",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5005394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles James Wentz Jr., MA, LCMHCS, LPC
• Marlena C White, PA-C
• Tia White
• Crystal Whitted
• Jerry Wilkes Jr., PHARMD
• William R Armstrong Jr (Laurinburg Chiropractic Center)
• Alejandra Williams
• Bailey Forbes Williams, RPH
• Lasandra Williams
• Phyllis Mack Wilson, PA-C

• Family Nurse Practitioner in Laurinburg, NC
• Providers in Laurinburg, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.