Active NPI
Kaliyann Te, PA-C
- Physician Assistant
- Winston Salem, NC
National Provider Identifier
1356764690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-04770
- Practice address
- Medical Center Blvd
Winston Salem, NC 27157-3736 - Phone
- (336) 713-4500
- Fax
- (336) 713-4501
- NPI assigned
- Jan 22, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-04770 | NC | Primary |
| Physician Assistant | 363A00000X | 001004770 | NC |
Addresses
Primary practice location
Medical Center Blvd
Winston Salem, NC 27157-3736
Mailing address
100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 716-0238
Other practice location 1
2150 Herbert Ct
Greenville, NC 27834-3736
Phone (252) 744-4963
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13347760 | Other | NC | PHCS-MULTIPLAN |
| 1356764690 | Medicaid | NC | |
| 1458919 | Other | NC | COVENTRY OF THE CAROLINAS |
| FH4001665 | Other | NC | FIRST CAROLINA CARE |
| 250511 | Other | NC | MEDCOST |
| 4293725 | Other | NC | COVENTRY NATIONAL - COVENTRY PPO |
| 1356764690 | Other | NC | HUMANA |
| 1458919 | Other | NC | WELLPATH |
| 1356764690 | Other | NC | HEALTHNET FEDERAL SERVICES |
| 4952804 | Other | NC | AETNA |
| 185TD | Other | NC | BCBS OF NC |
| 1356764690 | Other | NC | HEALTHSMART |
| 1356764690 | Other | NC | DOCTORS DIRECT |
| 3819841 | Other | NC | UNITED HEALTHCARE |
| 6877441 | Other | NC | CIGNA-GREATWEST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-04770 | NC | MD | Physician Assistant |
| 001004770 | NC | MD | Physician Assistant |
Interoperability endpoints
- kte2902556@carolinashealthcaresystem.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735862400000",
"number": "1356764690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 KIMEL FOREST DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271036074",
"telephone_number": "336-716-0238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MEDICAL CENTER BLVD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271573736",
"telephone_number": "336-713-4500",
"fax_number": "336-713-4501"
}
],
"practiceLocations": [
{
"address_1": "2150 Herbert Ct",
"address_purpose": "LOCATION",
"city": "Greenville",
"state": "NC",
"postal_code": "278343736",
"country_code": "US",
"telephone_number": "252-744-4963",
"fax_number": "252-744-2791",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TE",
"first_name": "KALIYANN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-22",
"last_updated": "2025-01-03",
"certification_date": "2025-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-04770",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "001004770",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS-MULTIPLAN",
"identifier": "13347760",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1356764690",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY OF THE CAROLINAS",
"identifier": "1458919",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST CAROLINA CARE",
"identifier": "FH4001665",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "250511",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY NATIONAL - COVENTRY PPO",
"identifier": "4293725",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "1356764690",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLPATH",
"identifier": "1458919",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET FEDERAL SERVICES",
"identifier": "1356764690",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4952804",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NC",
"identifier": "185TD",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHSMART",
"identifier": "1356764690",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DOCTORS DIRECT",
"identifier": "1356764690",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "3819841",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA-GREATWEST",
"identifier": "6877441",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.