Keith Leon Hutchins Jr., PA-C, DHSC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

0010-00581 Issued in NC

Practice address

171 NC Highway 125
Roanoke Rapids, NC 27870-6460

Phone

(252) 537-5631

Fax

(252) 537-7198

NPI assigned

Aug 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

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

Physician Assistant

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians

Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ecu Health North Hospital Hospital, Roanoke Rapids, NC, CCN 340151
• Bon Secours Southern Virginia Medical Center Hospital, Emporia, VA, CCN 490097

Merit-based Incentive Payment System (MIPS)

Final score

96.95 of 100Reported as apm

Quality

82.44

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: khutchins22859@direct.vidanthealth.com
• Direct secure messaging: khutchins22859@direct.ecuhealth.com

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.

• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment Care Compare group NPD
• Emergeortho PA

  • Orthopaedic Surgery Physician
  • Durham, NC
  • NPI 1376592964
  Medicare reassignment NPD
• Emergeortho PA

  • Durable Medical Equipment & Medical Supplies
  • Eden, NC
  • NPI 1841170222
  NPD
• Vidant Medical Group LLC

  • Ambulatory Surgical Clinic/Center
  • Kinston, NC
  • NPI 1376049619
  NPD
• Moye Medical Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Greenville, NC
  • NPI 1508041666
  NPD (past)
• Charleston Emergency Services LLC

  • Emergency Medicine Physician
  • Charleston, SC
  • NPI 1245344902
  NPD (past)

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

• Halifax Regional Medical Center Inc

  • General Acute Care Hospital
  • Roanoke Rapids, NC
  • NPI 1346273943
  Care Compare affiliation
• Bon Secours Mercy Health Emporia LLC

  • General Acute Care Hospital
  • Emporia, VA
  • NPI 1104461276
  Care Compare affiliation

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1376536714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 STANTONSBURG RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342818",
            "telephone_number": "252-537-5631",
            "fax_number": "252-537-7198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 NC HIGHWAY 125",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278706460",
            "telephone_number": "252-537-5631",
            "fax_number": "252-537-7198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHINS",
        "first_name": "KEITH",
        "middle_name": "LEON",
        "name_suffix": "Jr.",
        "credential": "PA-C, DHSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2023-03-07",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-00581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0010-00581",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376536714",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE FOR PA'S",
            "identifier": "1009",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khutchins22859@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Samantha Taylor Hudson, MS, PHARMD
• John C Huffman, MD
• Andrew Chandler Huggins, PHARMD
• James Henry Hunter Jr., M.ED.
• Kaitlyn Smith Hurdle
• Igr Collaborations
• Paulette Keith Ingram, M.D.
• Elizabeth Little Inscoe, NP
• Integrated Family Services, PLLC
• Interim Healthcare - Morris Group Inc

• Surgical Physician Assistant in Roanoke Rapids, NC
• Providers in Roanoke Rapids, NC by specialty
• Surgical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.