Individual provider Active NPI

Michael Avery Kepley, M.D.

  • Obstetrics & Gynecology Physician
  • Jefferson, NC
National Provider Identifier
1316939036
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
27876 Issued in NC
Practice address
200 Hospital Ave
Jefferson, NC 28640-9244
Phone
(336) 846-0821
NPI assigned
Aug 18, 2005
Last updated
Jun 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 27876 NC Primary

Addresses

Primary practice location

200 Hospital Ave
Jefferson, NC 28640-9244

Mailing address

200 Hospital Ave
Jefferson, NC 28640-9244
Phone (336) 846-0805

Other identifiers 2

IdentifierTypeStateIssuer
48525OtherNCBLUE CROSS BLUE SHIELD
8948525MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michael.kepley.1@4693.direct.athenahealth.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091012000415 NC Practitioner - Obstetrics/Gynecology 0749326379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of North Carolina at Chapel Hill School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ashe Multispecialty Group LLCGroup PAC ID 8022296318, 8 clinicians

Practice addresses (Care Compare)

200 Hospital Ave
Jefferson, NC 28640-9244
Phone (336) 846-7101

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27876NCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ashe Multispecialty Group, LLC CurrentSince Apr 22, 2023 Accepting new patients
Ashe Multispecialty Group, LLC CurrentSince Apr 22, 2023 Accepting new patients
Ashe Multispecialty Group, LLC Obstetrics & Gynecology Current Accepting new patients

Locations

200 Hospital Ave
Jefferson, NC 28640
Phone (336) 246-7101

Interoperability endpoints

  • Direct secure messaging: michael.kepley.1@14562.direct.athenahealth.com
  • Direct secure messaging: michael.kepley.1@29571.direct.athenahealth.com
  • Direct secure messaging: michael.kepley.1@4693.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1316939036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL AVE",
            "city": "JEFFERSON",
            "state": "NC",
            "postal_code": "286409244",
            "telephone_number": "336-846-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL AVE",
            "city": "JEFFERSON",
            "state": "NC",
            "postal_code": "286409244",
            "telephone_number": "336-846-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPLEY",
        "first_name": "MICHAEL",
        "middle_name": "AVERY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "27876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "48525",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8948525",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.kepley.1@4693.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct access",
            "address_1": "1446 Fern Creek Dr",
            "city": "Statesville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "286259376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jefferson, NC

Sources for this page

Verify at the official NPI Registry.