Active NPI
Kayla Diane Lerro
- Physician Assistant
- Raleigh, NC
National Provider Identifier
1790222891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-06976
- Practice address
- 3821 Ed Dr
Raleigh, NC 27612-8038 - Phone
- (919) 758-8677
- NPI assigned
- Jan 26, 2017
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-06976 | NC | Primary |
Addresses
Primary practice location
3821 Ed Dr
Raleigh, NC 27612-8038
Mailing address
3821 Ed Dr
Raleigh, NC 27612-8038
Phone (919) 758-8677
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 |
|---|---|---|---|
| 0010-06976 | NC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609977600000",
"number": "1790222891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3821 ED DR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276128038",
"telephone_number": "919-758-8677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3821 ED DR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276128038",
"telephone_number": "919-758-8677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LERRO",
"first_name": "KAYLA",
"middle_name": "DIANE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-26",
"last_updated": "2021-01-07",
"certification_date": "2021-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-06976",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.