Individual provider Active NPI

Kayleigh Ann Gilmore, PA-C

  • Physician Assistant
  • Garner, NC
National Provider Identifier
1588029052
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-06023 Issued in NC
Practice address
811 US 70 Hwy W
Garner, NC 27529-2541
Phone
(919) 235-6565
NPI assigned
Dec 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-06023 NC
Physician Assistant 363A00000X 0010-06023 NC Primary

Addresses

Primary practice location

811 US 70 Hwy W
Garner, NC 27529-2541

Mailing address

PO Box 603949
Charlotte, NC 28260-3949
Phone (919) 350-0351

Other practice location 1

2001 Sunset Ave
Rocky Mount, NC 27804-2523
Phone (252) 458-2508

Other identifiers 1

IdentifierTypeStateIssuer
1588029052MedicaidNC

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
I20160314001073 NC Practitioner - Physician Assistant 5496051716 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fastmed PCGroup PAC ID 9830540558, 174 clinicians
Wakemed Specialists Group LLCGroup PAC ID 2466788377, 868 clinicians

Practice addresses (Care Compare)

1311 E Millbrook Rd
Raleigh, NC 27609-5473
Phone (919) 719-0119

231 N Judd Pkwy NE
Fuquay Varina, NC 27526-2694
Phone (919) 232-0322

2908 N Herritage St
Kinston, NC 28501-1580
Phone (252) 523-3111

2930 Forestville Rd
Raleigh, NC 27616-8774
Phone (919) 235-6500

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-7270

3420 Ten Ten Rd
Suite 318
Cary, NC 27518-6101
Phone (919) 362-5871

5156 Veterans Pkwy
Garner, NC 27529-8417
Phone (919) 329-5000

7010 NC Hwy 751
Durham, NC 27707-5733
Phone (919) 313-3900

811 US 70 Hwy W
Garner, NC 27529-2541
Phone (919) 235-6565

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-06023NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group LLC CurrentSince Sep 30, 2019 Accepting new patients
Wakemed Specialists Group LLC CurrentSince Sep 30, 2019 Accepting new patients
Fastmed Primary Care, P.C. Past Accepting new patients

Locations

811 US 70 Hwy W
Garner, NC 27529
Phone (919) 235-6565

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

Organizations & group practices 5

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 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": "1451260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1588029052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603949",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603949",
            "telephone_number": "919-350-0351",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 US 70 HWY W",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292541",
            "telephone_number": "919-235-6565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 Sunset Ave",
            "address_purpose": "LOCATION",
            "city": "Rocky Mount",
            "state": "NC",
            "postal_code": "278042523",
            "country_code": "US",
            "telephone_number": "252-458-2508",
            "fax_number": "919-882-9570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "KAYLEIGH",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-28",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-06023",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588029052",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garner, NC

Sources for this page

Verify at the official NPI Registry.