NPIMap

Individual provider Active NPI

Kelly Ann Atkins

  • Family Nurse Practitioner
  • Elizabeth City, NC
National Provider Identifier
1710336128
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5008539 Issued in NC
Practice address
100 Medical Dr
Elizabeth City, NC 27909-3361
Phone
(252) 384-2600
Fax
(252) 335-2731
NPI assigned
Jun 7, 2016
Last updated
Apr 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5008539 NC Primary

Addresses

Primary practice location

100 Medical Dr
Elizabeth City, NC 27909-3361

Mailing address

100 Medical Dr
Elizabeth City, NC 27909-3361
Phone (252) 384-2600

Other practice location 1

100 Witmer Rd
#200
Horsham, PA 19044-2251
Phone (888) 766-5211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160822002881 NC Practitioner - Nurse Practitioner 7810282456 Reassigns benefits to 1 organization
I20180108003187 VA Practitioner - Nurse Practitioner 7810282456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Medical Dr
Elizabeth City, NC 27909-3361
Phone (252) 384-2600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Albemarle Physician Services - Sentara, Inc CurrentSince Oct 16, 2017 Accepting new patients
Tidewater Emergency Medical Care, LTD. CurrentSince Nov 1, 2017 Accepting new patients
Albemarle Physician Services - Sentara, Inc CurrentSince Oct 16, 2017 Accepting new patients
Laurel Mill Emergency Physicians Past Accepting new patients
North Carolina Em I Medical Services P C Past Accepting new patients
Tidewater Emergency Medical Care PastSince Feb 2, 2020 Accepting new patients

Locations

211 Virginia Rd
Edenton, NC 27932
Phone (252) 384-2590

905 Thunder Rd
Ste 210
Elizabeth City, NC 27909
Phone (252) 334-0460

100 Medical Dr
Elizabeth Cty, NC 27909
Phone (252) 338-5183

1144 N Road St
Elizabeth Cty, NC 27909
Phone (252) 384-4610

446 Caratoke Hwy
Moyock, NC 27958
Phone (252) 435-1275

736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124

Interoperability endpoints

  • Direct secure messaging: katkins310492@direct.sentara.net

Organizations & group practices 6

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 7

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": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1710336128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL DR",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093361",
            "telephone_number": "252-384-2600",
            "fax_number": "252-335-2731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL DR",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093361",
            "telephone_number": "252-384-2600",
            "fax_number": "252-335-2731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Witmer Rd",
            "address_2": "#200",
            "address_purpose": "LOCATION",
            "city": "Horsham",
            "state": "PA",
            "postal_code": "190442251",
            "country_code": "US",
            "telephone_number": "888-766-5211",
            "fax_number": "877-293-1533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATKINS",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5008539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth City, NC

Sources for this page

Verify at the official NPI Registry.