Carolyn Green Kellaway, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001003031 Issued in NC

Practice address

5 Firstvillage Drive
Pinehurst, NC 28374

Phone

(910) 295-6831

Fax

(910) 295-0244

NPI assigned

Jun 27, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pinehurst Surgical Clinic PAGroup PAC ID 4587561394, 92 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Firsthealth Moore Regional Hospital Hospital, Pinehurst, NC, CCN 340115

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: carolyn.green.1@2847.direct.athenahealth.com
• Direct secure messaging: carolyngreen@psc.allscriptsdirect.net

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.

• Pinehurst Surgical Clinic PA

  • Surgery Physician
  • Pinehurst, NC
  • NPI 1962434324
  Medicare reassignment Care Compare group
• MCPC-9, LLC

  dba FirstHealth Surgical Specialties

  • Orthopaedic Surgery Physician
  • Rockingham, NC
  • NPI 1487919973
  NPD (past)

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

• Firsthealth of the Carolinas, Inc

  dba Firsthealth Bariatric Center

  • Obesity Medicine (Internal Medicine) Physician
  • Pinehurst, NC
  • NPI 1740463967

  Hospital

  Care Compare affiliation
• Firsthealth of the Carolinas, Inc

  dba Firsthealth Regional EMS System

  • Land Ambulance
  • Pinehurst, NC
  • NPI 1871610378

  Hospital

  Care Compare affiliation
• Firsthealth of the Carolinas, Inc.

  dba FirstHealth Cancer Center

  • Oncology Clinic/Center
  • Pinehurst, NC
  • NPI 1417010422

  Hospital

  Care Compare affiliation
• Firsthealth of the Carolinas, Inc.

  dba FH Moore Regional Hospital (Acute)

  • General Acute Care Hospital
  • Pinehurst, NC
  • NPI 1740208081
  Care Compare affiliation

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1457647604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 105",
            "city": "TROY",
            "state": "NC",
            "postal_code": "273710105",
            "telephone_number": "910-295-6831",
            "fax_number": "910-295-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 FIRSTVILLAGE DRIVE",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "28374",
            "telephone_number": "910-295-6831",
            "fax_number": "910-295-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLAWAY",
        "first_name": "CAROLYN",
        "middle_name": "GREEN",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-27",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "001003031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Keegan
• Michele Philbrick Keel, OD
• Autumn Kegebein
• Karen Deanne Keisler, NP
• Tracy McNeill Keister, RN
• Robert Michael Keller, PA-C
• Kimberly B Kelley, DPT, PT
• Todd Lawrence Kelly, MD
• Steven M Kent, MD
• Margaret Susan Kepich, MD

• Medical Physician Assistant in Pinehurst, NC
• Providers in Pinehurst, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; 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.