NPIMap

Individual provider Active NPI

Mychal Kelly Powell, PA-C

  • Physician Assistant
  • Mebane, NC
National Provider Identifier
1720743354
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-11919 Issued in NC
Practice address
1352 Mebane Oaks Rd
Mebane, NC 27302-9681
Phone
(919) 525-3632
Fax
(919) 563-8453
NPI assigned
Nov 8, 2021
Last updated
Feb 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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 0010-11919 NC Primary

Addresses

Primary practice location

1352 Mebane Oaks Rd
Mebane, NC 27302-9681

Mailing address

5213 S Alston Ave
Durham, NC 27713-4430
Phone (919) 620-4855

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
I20220323002730 NC Practitioner - Physician Assistant 7113312406 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

7200 Creedmoor Rd
Suite 208
Raleigh, NC 27613-1711
Phone (919) 327-1650

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-11919NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Affiliated Physicians, Inc. Family Medicine CurrentSince Feb 7, 2022 Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine CurrentSince Feb 7, 2022 Accepting new patients

Locations

7200 Creedmoor Rd
Ste 208
Raleigh, NC 27613
Phone (919) 327-1650

Interoperability endpoints

  • Direct secure messaging: mpowell462378@direct.medicine.duke.edu

Organizations & group practices 4

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 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": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1720743354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5213 S ALSTON AVE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277134430",
            "telephone_number": "919-620-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1352 MEBANE OAKS RD",
            "city": "MEBANE",
            "state": "NC",
            "postal_code": "273029681",
            "telephone_number": "919-525-3632",
            "fax_number": "919-563-8453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "MYCHAL",
        "middle_name": "KELLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-08",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mebane, NC

Sources for this page

Verify at the official NPI Registry.