Individual provider Active NPI

Erica Paige Keen, PA-C

  • Physician Assistant
  • Wilmington, NC
National Provider Identifier
1417655598
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-13439 Issued in NC
Practice address
615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone
(910) 343-0145
NPI assigned
Feb 20, 2023
Last updated
Apr 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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 0010-13439 NC Primary

Addresses

Primary practice location

615 Shipyard Blvd
Wilmington, NC 28412-6431

Mailing address

615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 343-0145

Other practice location 1

120 Coastal Horizons Dr
Shallotte, NC 28470-6094
Phone (910) 754-4515

Other practice location 2

6 Doctors Cir
Supply, NC 28462-6357
Phone (910) 754-4233

Other practice location 3

110 Premiere Plz
Whiteville, NC 28472-2522
Phone (910) 524-8183

Other practice location 4

7876 US Hwy 117 S # A
Rocky Point, NC 28457-8408
Phone (910) 259-0668

Other practice location 5

240 Hospital Dr NE
Bolivia, NC 28422-8346
Phone (910) 721-1000

Other practice location 6

309 Progress Dr
Burgaw, NC 28425-3280
Phone (910) 259-0668

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240104002267 NC Practitioner - Physician Assistant 5890146781 Reassigns benefits to 2 organizations

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
Coastal Horizons Center, Inc.Group PAC ID 9739267964, 50 clinicians

Practice addresses (Care Compare)

615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 343-0145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-13439NCMDPhysician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1417655598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431",
            "telephone_number": "910-343-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431",
            "telephone_number": "910-343-0145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Coastal Horizons Dr",
            "address_purpose": "LOCATION",
            "city": "Shallotte",
            "state": "NC",
            "postal_code": "284706094",
            "country_code": "US",
            "telephone_number": "910-754-4515",
            "fax_number": "910-754-4515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6 Doctors Cir",
            "address_purpose": "LOCATION",
            "city": "Supply",
            "state": "NC",
            "postal_code": "284626357",
            "country_code": "US",
            "telephone_number": "910-754-4233",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Premiere Plz",
            "address_purpose": "LOCATION",
            "city": "Whiteville",
            "state": "NC",
            "postal_code": "284722522",
            "country_code": "US",
            "telephone_number": "910-524-8183",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7876 US Hwy 117 S # A",
            "address_purpose": "LOCATION",
            "city": "Rocky Point",
            "state": "NC",
            "postal_code": "284578408",
            "country_code": "US",
            "telephone_number": "910-259-0668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "240 Hospital Dr NE",
            "address_purpose": "LOCATION",
            "city": "Bolivia",
            "state": "NC",
            "postal_code": "284228346",
            "country_code": "US",
            "telephone_number": "910-721-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 Progress Dr",
            "address_purpose": "LOCATION",
            "city": "Burgaw",
            "state": "NC",
            "postal_code": "284253280",
            "country_code": "US",
            "telephone_number": "910-259-0668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEEN",
        "first_name": "ERICA",
        "middle_name": "PAIGE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-20",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.