Individual provider Active NPI

Katy Howell, PAC

  • Physician Assistant
  • Jacksonville, NC
National Provider Identifier
1750625190
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-04923 Issued in NC
Practice address
3280 Henderson Dr Ste C1
Jacksonville, NC 28546-5289
Phone
(910) 548-2818
NPI assigned
Nov 26, 2012
Last updated
May 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 003654 OH
Physician Assistant 363A00000X 0010-04923 NC Primary

Addresses

Primary practice location

3280 Henderson Dr Ste C1
Jacksonville, NC 28546-5289

Mailing address

3280 Henderson Dr Ste C1
Jacksonville, NC 28546-5289
Phone (910) 548-2818

Other practice location 1

395 W 12th Ave Ste 401
Columbus, OH 43210-1267
Phone (614) 293-3494

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
I20141104002409 NC Practitioner - Physician Assistant 7214182823

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-04923NCMDPhysician Assistant
003654OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Queens Empire Health CurrentSince May 9, 2021 Accepting new patients
Healthfirst Urgent Care PC CurrentSince Feb 24, 2020 Accepting new patients
Healthfirst Primary Care PC CurrentSince Feb 24, 2020 Accepting new patients
Queens Empire Health CurrentSince May 9, 2021 Accepting new patients
Starmed Urgent & Family Care, P.a. Physician Assistant PastSince Dec 1, 2019 Accepting new patients

Locations

3280 Henderson Dr
Ste C1
Jacksonville, NC 28546
Phone (718) 704-7620

3011B Raleigh Road Pkwy W
Wilson, NC 27896
Phone (252) 293-1010

Organizations & group practices 5

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": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1750625190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 HENDERSON DR STE C1",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465289",
            "telephone_number": "910-548-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 HENDERSON DR STE C1",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465289",
            "telephone_number": "910-548-2818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "395 W 12th Ave Ste 401",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101267",
            "country_code": "US",
            "telephone_number": "614-293-3494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOWELL",
        "first_name": "KATY",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2021-05-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "003654",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.