Individual provider Active NPI

Kelly Ann Erola, MD

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Wilmington, NC
National Provider Identifier
1609907955
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
License
02390 Issued in NC
Practice address
1414 Physicians Dr
Wilmington, NC 28401-7335
Phone
(910) 796-7900
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 39097 GA
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 02390 NC Primary

Addresses

Primary practice location

1414 Physicians Dr
Wilmington, NC 28401-7335

Mailing address

1414 Physicians Dr
Wilmington, NC 28401-7335

Other identifiers 2

IdentifierTypeStateIssuer
000656565PMedicaidGA
1609907955MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240311000399 NC Practitioner - Hospice/Palliative Care 8628008885 Reassigns benefits to 2 organizations
I20260304003839 SC Practitioner - Hospice/Palliative Care 8628008885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative Care
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1414 Physicians Dr
Wilmington, NC 28401-7335

1915 Port Cardiff PL
Newport Beach, CA 92660-5416

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
39097GAMDFamily Medicine Physician
02390NCMDHospice and Palliative Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lower Cape Fear Hospice Incorporated CurrentSince Jan 27, 2024 Accepting new patients
Lower Cape Fear Hospice, Incorporated Current Accepting new patients
Lower Cape Fear Hospice Incorporated CurrentSince Dec 22, 2025 Accepting new patients
Lower Cape Fear Hospice Incorporated Family Medicine Past Accepting new patients

Locations

1414 Physicians Dr
Wilmington, NC 28401
Phone (910) 796-7900

1314 3rd Ave
Conway, SC 29526
Phone (843) 848-6480

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lower Cape Fear LifecareConway, SC, CCN 421501 Hospice W-2 Managing Employee Jan 3, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1609907955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 PHYSICIANS DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 PHYSICIANS DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017335",
            "telephone_number": "910-796-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EROLA",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "39097",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "NC",
            "license": "02390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000656565P",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609907955",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.