Individual provider Active NPI

Kelly Kaylor Jaglowski, FNP-BC

  • Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1629796537
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5016744 Issued in NC
Practice address
2304 Wesvill CT Ste 360
Raleigh, NC 27607-2981
Phone
(919) 785-1220
NPI assigned
Aug 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5016744 NC Primary

Addresses

Primary practice location

2304 Wesvill CT Ste 360
Raleigh, NC 27607-2981

Mailing address

2304 Wesvill CT Ste 360
Raleigh, NC 27607-2981
Phone (919) 785-1220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5016744NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aesthetic & Reconstructive Plastic Surgery,PLLC CurrentSince Aug 28, 2022 Accepting new patients
American Anesthesiology of North Carolina, PLLC PastSince Aug 28, 2022 Accepting new patients

Locations

2304 Wesvill Ct
Ste 360
Raleigh, NC 27607
Phone (919) 785-1220

Organizations & group practices 2

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": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1629796537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 WESVILL CT STE 360",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276072981",
            "telephone_number": "919-785-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 WESVILL CT STE 360",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276072981",
            "telephone_number": "919-785-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGLOWSKI",
        "first_name": "KELLY",
        "middle_name": "KAYLOR",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5016744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.