Katina Eley-Hardy, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

102844 Issued in NC

Practice address

120 Health Center Dr
Ahoskie, NC 27910-8161

Phone

(252) 332-3548

Fax

(252) 332-1665

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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, 1999

Medicare assignment

May accept Medicare assignment

Group practices

Roanoke Chowan Community Health Center IncGroup PAC ID 7214983386, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vidant Roanoke Chowan Hospital Hospital, Ahoskie, NC, CCN 340099

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: keleyhardy28185@direct.ochin.org

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.

• Roanoke Chowan Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Colerain, NC
  • NPI 1790851004
  Medicare reassignment Care Compare group NPD
• Roanoke Chowan Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Woodland, NC
  • NPI 1023675113
  NPD
• Roanoke Chowan Women'S Center, PA

  • Specialist
  • Ahoskie, NC
  • NPI 1528230240
  NPD (past)

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

• East Carolina Health

  • General Acute Care Hospital
  • Ahoskie, NC
  • NPI 1467441394
  Care Compare affiliation

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1619087640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 669",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279100669",
            "telephone_number": "252-209-0237",
            "fax_number": "252-209-0197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HEALTH CENTER DR",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279108161",
            "telephone_number": "252-332-3548",
            "fax_number": "252-332-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELEY-HARDY",
        "first_name": "KATINA",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102844",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "102844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8101658",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beverly Edwards Edwards, MD
• Heather Michelle Edwards, PTA
• Matthew Scott Edwards, OD
• Michael Scott Edwards, OD
• Jeremy Dale Efird, PHARMD
• Elite Family Healthcare
• Elitex Staffing Solutions, LLC
• Brandon Elvis, CRNA
• Carla Dee Cooper Eure, FNP-C
• Joshua Warren Evans, MD, MPH

• Medical Physician Assistant in Ahoskie, NC
• Providers in Ahoskie, 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 Sep 23, 2016; 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.