NPIMap

Individual provider Active NPI

Kaley Nicole Williford

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1669228730
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
10650 Park Rd
Charlotte, NC 28210-8538
Phone
(384) 070-4667
NPI assigned
Apr 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

10650 Park Rd
Charlotte, NC 28210-8538

Mailing address

5814 Newell Dr
Monroe, NC 28112-6767
Phone (704) 794-8225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250329000128 NC Practitioner - Physician Assistant 5496278574 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

100 Medical Park Dr
Concord, NC 28025-2966

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000

134 Medical Park Rd
Suite 111
Mooresville, NC 28117-8527
Phone (704) 801-9100

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Carolinas Medical Center-Northeast Hospital, Concord, NC, CCN 340001

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Mar 24, 2025 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Mar 24, 2025 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Mar 24, 2025 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Mar 24, 2025 Accepting new patients
Carolinas Medical Center CurrentSince Mar 24, 2025 Accepting new patients
Carolinas Medical Center CurrentSince Mar 24, 2025 Accepting new patients

Locations

10650 Park Rd
Charlotte, NC 28210
Phone (704) 667-0337

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

100 Medical Park Dr
Ste 210
Concord, NC 28025
Phone (704) 403-6100

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

Interoperability endpoints

  • Direct secure messaging: kwilliford2742581@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 9

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 8

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": "1714348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1669228730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5814 NEWELL DR",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281126767",
            "telephone_number": "704-794-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10650 PARK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108538",
            "telephone_number": "384-070-4667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIFORD",
        "first_name": "KALEY",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-29",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.