Active NPI
Lorraine Ellen Kelly, NP
- Nurse Practitioner
- Wilmington, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5015395
- Practice address
- 1725 New Hanover Medical Park Dr
Wilmington, NC 28403-5345 - Phone
- (910) 662-9300
- Fax
- (910) 662-9301
- NPI assigned
- Nov 30, 2021
- Last updated
- Jul 30, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5015395 | NC | Primary |
| Primary Care Nurse Practitioner | 363LP2300X | 5015395 | NC |
Addresses
Primary practice location
1725 New Hanover Medical Park Dr
Wilmington, NC 28403-5345
Mailing address
PO Box 936857
Atlanta, GA 31193-6857
Other practice location 1
2580 Pickard Rd
Wilmington, NC 28403-4461
Phone (910) 332-0701
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220310002788 | NC | Practitioner - Nurse Practitioner | 4688069586 |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2580 Pickard Rd
Wilmington, NC 28403-4461
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Intracoastal Internal Medicine | Current | Accepting new patients |
Locations
2580 Pickard Rd
Wilmington, NC 28403
Phone (910) 332-0701
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IIJBAA
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Wilmington, NC
- NPI 1770515272
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Novant Health New Hanover Regional Medical Center
- General Acute Care Hospital
- Wilmington, NC
- NPI 1376139139
-
- Home Health Agency
- Wilmington, NC
- NPI 1760470660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785369600000",
"number": "1629736376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 936857",
"city": "ATLANTA",
"state": "GA",
"postal_code": "311936857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1725 NEW HANOVER MEDICAL PARK DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284035345",
"telephone_number": "910-662-9300",
"fax_number": "910-662-9301"
}
],
"practiceLocations": [
{
"address_1": "2580 Pickard Rd",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "NC",
"postal_code": "284034461",
"country_code": "US",
"telephone_number": "910-332-0701",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KELLY",
"first_name": "LORRAINE",
"middle_name": "ELLEN",
"name_prefix": "Ms.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-30",
"last_updated": "2026-07-30",
"certification_date": "2026-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "5015395",
"primary": true
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "NC",
"license": "5015395",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2026; 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.