NPIMap

Individual provider Active NPI

Kyle Jeffrey McCarthy, PA-C

  • Physician Assistant
  • Fayetteville, NC
National Provider Identifier
1316660152
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-12619 Issued in NC
Practice address
1638 Owen Dr
Fayetteville, NC 28304-3424
Phone
(910) 615-4000
NPI assigned
Sep 26, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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 0010-12619 NC Primary

Addresses

Primary practice location

1638 Owen Dr
Fayetteville, NC 28304-3424

Mailing address

3508 Chestnut RDG
Tannersville, PA 18372-7846
Phone (570) 982-4940

Other practice location 1

711 Executive Pl
Fayetteville, NC 28305-5193
Phone (910) 615-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230321001722 NC Practitioner - Physician Assistant 9436523172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-4000

711 Executive PL
Fayetteville, NC 28305-5193
Phone (910) 615-3333

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-12619NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland County Hospital System Inc CurrentSince Dec 7, 2022 Accepting new patients
Cumberland County Hospital System Inc Past Accepting new patients

Locations

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

Interoperability endpoints

  • Direct secure messaging: kmccarthy107014@capefearvalley.direct-ci.com

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1316660152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3508 CHESTNUT RDG",
            "city": "TANNERSVILLE",
            "state": "PA",
            "postal_code": "183727846",
            "telephone_number": "570-982-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-615-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 Executive Pl",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283055193",
            "country_code": "US",
            "telephone_number": "910-615-3333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "KYLE",
        "middle_name": "JEFFREY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-26",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.