Active NPI
Kelly Wayne Styron, DPT
- Physical Therapist
- Morehead City, NC
National Provider Identifier
1396930004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11300
- Practice address
- 3700 Symi Cir
Morehead City, NC 28557-4309 - Phone
- (252) 247-2738
- Fax
- (252) 240-2738
- NPI assigned
- Sep 6, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11300 | NC | Primary |
Addresses
Primary practice location
3700 Symi Cir
Morehead City, NC 28557-4309
Mailing address
1910 N Church St
Ste D
Greensboro, NC 27405-5632
Phone (336) 274-7480
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 068W1 | Other | NC | BCBS NC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11300 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269561600000",
"number": "1396930004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1910 N CHURCH ST",
"address_2": "STE D",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274055632",
"telephone_number": "336-274-7480",
"fax_number": "336-274-8903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 SYMI CIR",
"city": "MOREHEAD CITY",
"state": "NC",
"postal_code": "285574309",
"telephone_number": "252-247-2738",
"fax_number": "252-240-2738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STYRON",
"first_name": "KELLY",
"middle_name": "WAYNE",
"name_prefix": "Mr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-06",
"last_updated": "2010-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "11300",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NC",
"identifier": "068W1",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Morehead City, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.