Individual provider Active NPI

Katelin Lee Welsh, PA-C

  • Physician Assistant
  • Conover, NC
National Provider Identifier
1679915383
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-14074 Issued in NC
Practice address
711 Fairgrove Church Rd SE
Conover, NC 28613-8680
Phone
(828) 855-3636
Fax
(828) 855-3638
NPI assigned
Jul 23, 2013
Last updated
May 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 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 0010-14074 NC Primary

Addresses

Primary practice location

711 Fairgrove Church Rd SE
Conover, NC 28613-8680

Mailing address

711 Fairgrove Church Rd SE
Conover, NC 28613-8680
Phone (828) 855-3636

Other names 1

  • Katelin Lee Wantz Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240524002293 NC Practitioner - Physician Assistant 3971747734 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-14074NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hanover Health Corporation Past Accepting new patients
Emergency Medicine Physicians of York County, LTD Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kwantz95435@wellspan.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1679915383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 FAIRGROVE CHURCH RD SE",
            "city": "CONOVER",
            "state": "NC",
            "postal_code": "286138680",
            "telephone_number": "828-855-3636",
            "fax_number": "828-855-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 FAIRGROVE CHURCH RD SE",
            "city": "CONOVER",
            "state": "NC",
            "postal_code": "286138680",
            "telephone_number": "828-855-3636",
            "fax_number": "828-855-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELSH",
        "first_name": "KATELIN",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2025-05-20",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-14074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELIN",
            "last_name": "WANTZ",
            "middle_name": "LEE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Conover, NC

Sources for this page

Verify at the official NPI Registry.