Individual provider Active NPI

Kelley Thomas, FNP-C

  • Family Nurse Practitioner
  • Wilmington, NC
National Provider Identifier
1750761821
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5007724 Issued in NC
Practice address
230 Government Center Dr Ste 154
Wilmington, NC 28403-1696
Phone
(910) 798-7193
Fax
(910) 798-7317
NPI assigned
Jun 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Registered Nurse 163W00000X 245453 NC
Family Nurse Practitioner 363LF0000X 5007724 NC Primary

Addresses

Primary practice location

230 Government Center Dr Ste 154
Wilmington, NC 28403-1696

Mailing address

230 Government Center Dr Ste 154
Wilmington, NC 28403-1696
Phone (910) 798-7193

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
I20151211001666 NC Practitioner - Nurse Practitioner 0446551634

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
245453NCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care PLLC Family CurrentSince Nov 5, 2024 Accepting new patients

Locations

6840 Glenwood Ave
Raleigh, NC 27612
Phone (401) 770-4415

2340 Spring Forest Rd
Raleigh, NC 27615
Phone (919) 790-6401

13304 Leesville Church Rd
Raleigh, NC 27617
Phone (919) 845-2489

4600 Oleander Dr
Wilmington, NC 28403
Phone (910) 392-1921

6901 Market St
Wilmington, NC 28411
Phone (910) 262-6161

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1750761821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 GOVERNMENT CENTER DR STE 154",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284031696",
            "telephone_number": "910-798-7193",
            "fax_number": "910-798-7317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 GOVERNMENT CENTER DR STE 154",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284031696",
            "telephone_number": "910-798-7193",
            "fax_number": "910-798-7317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KELLEY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-04",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "245453",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5007724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.