Kristen Blanche Talty McLeroy, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-14512 Issued in NC

Practice address

2020 N Peace Haven Rd
Winston Salem, NC 27106-4851

Phone

(336) 768-1280

NPI assigned

May 23, 2024

Last updated

Sep 26, 2024By the provider in NPPES

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

Other names 1

• Kristen Blanche Talty Green Former name

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

Wake Forest University School of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Westgate Dermatology and Laser Center, P.a.Group PAC ID 8325104714, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Westgate Dermatology and Laser Center, P.a.

  • Dermatopathology Physician
  • Winston Salem, NC
  • NPI 1821240995
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1487493912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 WESTFIELD AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033643",
            "telephone_number": "757-692-0257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 N PEACE HAVEN RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271064851",
            "telephone_number": "336-768-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEROY",
        "first_name": "KRISTEN",
        "middle_name": "BLANCHE TALTY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-14512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "GREEN",
            "middle_name": "BLANCHE TALTY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Thomas Williams McLean, MD
• Jerri Lynn McLemore, M.D.
• Rebecca J. McLemore, MSW, LCSWA
• Ryan James McLennan, MD
• Amanda Melinda McLeroy, MS, LCMHCA, NCC
• Virginia Mistretta McLin, MN, NNP-BC
• Demicka Tryne McMahan
• Stephen Higgins McMahon, MD
• Danielle Grace McManus, PA-C
• John M McManus, MD

• Physician Assistant in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.