Individual provider Active NPI

Larry Shelton Kilby, M.D.

  • Adult Medicine Physician
  • Winston Salem, NC
National Provider Identifier
1710174636
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
15953 Issued in NC
Practice address
1710 S Hawthorne Rd
Winston Salem, NC 27103-4016
Phone
(336) 765-6897
Fax
(336) 765-7306
NPI assigned
Sep 25, 2007
Last updated
Jan 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 15953 NC Primary

Addresses

Primary practice location

1710 S Hawthorne Rd
Winston Salem, NC 27103-4016

Mailing address

1710 S Hawthorne Rd
Winston Salem, NC 27103-4016
Phone (336) 765-6897

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070822001208 NC Practitioner - Internal Medicine 4688685209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wake Forest University School of Medicine, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Larry S Kilby MD PAGroup PAC ID 0547564825, 5 clinicians

Practice addresses (Care Compare)

1710 S Hawthorne Rd
Winston Salem, NC 27103-4016
Phone (336) 765-6897

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15953NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Larry S Kilby MD PA Adult Medicine CurrentSince Dec 1, 2015 Accepting new patients

Locations

150 Charlois Blvd
Ste 100
Winston Salem, NC 27103
Phone (336) 718-7470

1710 S Hawthorne Rd
Winston Salem, NC 27103
Phone (336) 765-0960

730 Highland Oaks Dr
Ste 101
Winston Salem, NC 27103
Phone (336) 765-6897

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.

Hospital & facility affiliations 1

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": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1710174636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 S HAWTHORNE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034016",
            "telephone_number": "336-765-6897",
            "fax_number": "336-765-7306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 S HAWTHORNE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034016",
            "telephone_number": "336-765-6897",
            "fax_number": "336-765-7306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILBY",
        "first_name": "LARRY",
        "middle_name": "SHELTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-25",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NC",
            "license": "15953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.