NPIMap

Individual provider Active NPI

Kelissa Stacy Shillingford, MD

  • Family Medicine Physician
  • Durham, NC
National Provider Identifier
1427545508
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2021-00762 Issued in NC
Practice address
6020 Fayetteville Rd
Durham, NC 27713-9754
Phone
(919) 572-2000
NPI assigned
Apr 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2021-00762 NC Primary

Addresses

Primary practice location

6020 Fayetteville Rd
Durham, NC 27713-9754

Mailing address

6020 Fayetteville Rd
Durham, NC 27713-9754
Phone (919) 572-2000

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
I20210803001091 NC Practitioner - Family Practice 8921402637 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

150 Robeson St
Fayetteville, NC 28301-5570
Phone (910) 615-1059

162 Legacy Oaks Dr
Suite 101
Knightdale, NC 27545-6557
Phone (919) 373-1800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2021-00762NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Affiliated Physicians, Inc. Family Medicine CurrentSince Aug 9, 2021 Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine CurrentSince Aug 9, 2021 Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine Current Accepting new patients
Cumberland County Hospital System Inc Current Accepting new patients
Cumberland County Hospital System Inc Family Medicine CurrentSince May 23, 2023 Accepting new patients
CFV Express Care Billing Services LLC Family Medicine CurrentSince May 23, 2023 Accepting new patients
Cumberland County Hospital System Inc CurrentSince May 23, 2023 Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine Current Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine Past Accepting new patients

Locations

6020 Fayetteville Rd
Durham, NC 27713
Phone (919) 572-2000

5716 Fayetteville Rd
Durham, NC 27713
Phone (919) 572-1862

1901 Hillandale Rd
Ste D
Durham, NC 27705
Phone (919) 383-4355

6387 Ramsey St
Unit 100
Fayetteville, NC 28311
Phone (910) 615-3879

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

150 Robeson St
Fayetteville, NC 28301
Phone (910) 609-1000

267 S Churton St
Ste 200
Hillsborough, NC 27278
Phone (919) 471-9622

401 Irving Pkwy
Ste 110
Holly Springs, NC 27540
Phone (919) 385-3022

162 Legacy Oaks Dr
Knightdale, NC 27545
Phone (919) 373-1800

162 Legacy Oaks Dr
Ste 101
Knightdale, NC 27545
Phone (919) 232-5205

10208 Cerny St
Ste 210
Raleigh, NC 27617
Phone (919) 457-0340

10211 Alm St
Raleigh, NC 27617
Phone (919) 206-4868

7021 Harps Mill Rd
Raleigh, NC 27615
Phone (919) 823-5446

3000 Rogers Rd
Ste 100
Wake Forest, NC 27587
Phone (919) 367-1729

Interoperability endpoints

  • Direct secure messaging: kshillingford489515@direct.medicine.duke.edu
  • Direct secure messaging: kshillingford98646@capefearvalley.direct-ci.com

Organizations & group practices 9

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 9

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

NPI Registry JSON

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

{
    "created_epoch": "1523750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1427545508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 FAYETTEVILLE RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277139754",
            "telephone_number": "919-572-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 FAYETTEVILLE RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277139754",
            "telephone_number": "919-572-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHILLINGFORD",
        "first_name": "KELISSA",
        "middle_name": "STACY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-15",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2021-00762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.