Individual provider Active NPI

Kelley Osborne Manuel, FNP

  • Nurse Practitioner
  • Mount Airy, NC
National Provider Identifier
1508386889
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5009620 Issued in NC
Practice address
1016 S South St
Mount Airy, NC 27030-5330
Phone
(336) 783-8900
Fax
(336) 783-3417
NPI assigned
Jun 27, 2017
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5009620 NC Primary
Family Nurse Practitioner 363LF0000X 5009620 NC

Addresses

Primary practice location

1016 S South St
Mount Airy, NC 27030-5330

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 716-2255

Other practice location 1

2005 Pisgah Church Rd
Greensboro, NC 27455-3309
Phone (336) 716-9150

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
I20170920003399 NC Practitioner - Nurse Practitioner 1456625060 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Airy Emergency Physicians PLLCGroup PAC ID 2567363252, 9 clinicians

Practice addresses (Care Compare)

1016 S S St
Mount Airy, NC 27030-5330
Phone (336) 783-8900

423 S S St
Mount Airy, NC 27030-4576
Phone (336) 786-5144

830 Rockford St
Mount Airy, NC 27030-5322
Phone (336) 783-8374

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5009620NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince May 19, 2025 Accepting new patients
Northern Hospital of Surry County CurrentSince Oct 1, 2017 Accepting new patients
Northern Hospital of Surry County Current Accepting new patients
Northern Hospital of Surry County CurrentSince Oct 1, 2017 Accepting new patients
Northern Hospital District of Surry County CurrentSince Oct 1, 2020 Accepting new patients
Mount Airy Emergency Physicians, PLLC CurrentSince Jan 27, 2026 Accepting new patients
Northern Hospital District of Surry County CurrentSince Oct 1, 2020 Accepting new patients
Northern Hospital of Surry County Past Accepting new patients
Northern Hospital District of Surry County PastSince Apr 6, 2021 Accepting new patients

Locations

2005 Pisgah Church Rd
Greensboro, NC 27455
Phone (336) 701-2662

1016 S South St
Mount Airy, NC 27030
Phone (336) 783-8900

119 Welch Rd
Ste A
Mount Airy, NC 27030
Phone (336) 719-6200

280 N Pointe Blvd
Mount Airy, NC 27030
Phone (336) 786-4133

423 S South St
Mount Airy, NC 27030
Phone (336) 786-5144

708 S South St
#300
Mount Airy, NC 27030
Phone (336) 783-8030

830 Rockford St
Mount Airy, NC 27030
Phone (336) 719-7000

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: kmanuel@direct.nrh.nchie.net
  • Direct secure messaging: kmanuel@nmgfm.gwaydirect.com
  • Direct secure messaging: kmanuel3007107@carolinashealthcaresystem.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1508386889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-716-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 S SOUTH ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270305330",
            "telephone_number": "336-783-8900",
            "fax_number": "336-783-3417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2005 Pisgah Church Rd",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274553309",
            "country_code": "US",
            "telephone_number": "336-716-9150",
            "fax_number": "336-702-9166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANUEL",
        "first_name": "KELLEY",
        "middle_name": "OSBORNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5009620",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5009620",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, NC

Sources for this page

Verify at the official NPI Registry.