Individual provider Active NPI

Kelcie Renae Thames, DNP-C

  • Family Nurse Practitioner
  • Roxboro, NC
National Provider Identifier
1457015703
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5016172 Issued in NC
Practice address
796 Doctors CT
Roxboro, NC 27573-4571
Phone
(336) 598-0002
Fax
(336) 599-2159
NPI assigned
Oct 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5016172 NC Primary
Family Nurse Practitioner 363LF0000X F10210943 TN

Addresses

Primary practice location

796 Doctors CT
Roxboro, NC 27573-4571

Mailing address

796 Doctors CT
Roxboro, NC 27573-4571
Phone (336) 598-0002

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
I20220630000328 NC Practitioner - Nurse Practitioner 0446630958 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F10210943TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rising Integrative Healthcare of Wilmington, PLLC CurrentSince Aug 1, 2022 Accepting new patients
Roxboro Internal Medicine & Pediatrics, P.a. Past Accepting new patients

Locations

504 Red Banks Rd
Ste C
Greenville, NC 27858
Phone (252) 321-3579

5 Silva Terra Dr
Ste 100
Wilmington, NC 28412
Phone (910) 523-5176

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.

NPI Registry JSON

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

{
    "created_epoch": "1634947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764115200000",
    "number": "1457015703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "796 DOCTORS CT",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275734571",
            "telephone_number": "336-598-0002",
            "fax_number": "336-599-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "796 DOCTORS CT",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275734571",
            "telephone_number": "336-598-0002",
            "fax_number": "336-599-2159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAMES",
        "first_name": "KELCIE",
        "middle_name": "RENAE",
        "credential": "DNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-23",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5016172",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "F10210943",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxboro, NC

Sources for this page

Verify at the official NPI Registry.