NPIMap

Individual provider Active NPI

Kelly Christ, PA-C

  • Physician Assistant
  • Fayetteville, NC
National Provider Identifier
1376305730
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001013934 Issued in NC
Practice address
1340 Walter Reed Rd Ste 101
Fayetteville, NC 28304-4451
Phone
(910) 401-5425
NPI assigned
Jan 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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 001013934 NC Primary

Addresses

Primary practice location

1340 Walter Reed Rd Ste 101
Fayetteville, NC 28304-4451

Mailing address

PO Box 96860
Charlotte, NC 28296-6860

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
I20240227004661 NC Practitioner - Physician Assistant 1557706769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raleigh Durham Medical Group PAGroup PAC ID 2365409588, 80 clinicians

Practice addresses (Care Compare)

1340 Walter Reed Rd
Suite 101
Fayetteville, NC 28304-4451
Phone (910) 401-5425

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001013934NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Durham Medical Group PA CurrentSince Oct 1, 2024 Accepting new patients
Raleigh Durham Medical Group PA CurrentSince Oct 1, 2024 Accepting new patients

Locations

97 Cornerstone Dr
Cary, NC 27519
Phone (919) 460-0993

10620 Park Rd
Ste 128
Charlotte, NC 28210
Phone (704) 542-6111

1340 Walter Reed Rd
Ste 101
Fayetteville, NC 28304
Phone (910) 401-5425

7124 US Highway 64 E
Knightdale, NC 27545
Phone (919) 266-6211

Organizations & group practices 2

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1376305730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96860",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282966860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 WALTER REED RD STE 101",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044451",
            "telephone_number": "910-401-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRIST",
        "first_name": "KELLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-30",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001013934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.