Active NPI
Kimberly Anne Major, PAC
- Medical Physician Assistant
- Bolton, NC
National Provider Identifier
1720147986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 0010-05291
- Practice address
- 213 9TH St
Bolton, NC 28423-8410 - Phone
- (910) 655-8300
- Fax
- (910) 267-8997
- NPI assigned
- Dec 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 0010-05291 | NC | Primary |
Addresses
Primary practice location
213 9TH St
Bolton, NC 28423-8410
Mailing address
2218 Wilmington Rd
Southport, NC 28461-7942
Phone (352) 840-3058
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-05291 | NC | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Institute of Cardiovascular Excellence PLLC | Past | Accepting new patients |
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 and National Provider Directory roles.
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- Ocala, FL
- NPI 1295975803
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418774400000",
"number": "1720147986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2218 WILMINGTON RD",
"city": "SOUTHPORT",
"state": "NC",
"postal_code": "284617942",
"telephone_number": "352-840-3058",
"fax_number": "910-267-1237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "213 9TH ST",
"city": "BOLTON",
"state": "NC",
"postal_code": "284238410",
"telephone_number": "910-655-8300",
"fax_number": "910-267-8997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAJOR",
"first_name": "KIMBERLY",
"middle_name": "ANNE",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2014-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NC",
"license": "0010-05291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bolton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.