Kevin Thomas Slater, PA-C
Individual provider Active NPI Physician Assistant · Pinehurst, NC
NPI 1790792604 · NPPES record last updated Sep 11, 2018
Key facts
- NPI
- 1790792604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 103674 (NC)
- Practice address
- 5 First Village Drive
Pinehurst, NC 28374 - Phone
- (910) 295-6831
- Fax
- (910) 295-0244
- NPI assigned
- Aug 2, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- MCPC-9 LLC
Practice addresses (Care Compare)
155 Memorial Dr
Pinehurst, NC 28374-8710
809 S Long Dr
Rockingham, NC 28379-4377
Phone (910) 417-4096
Hospital & facility affiliations
- Firsthealth Moore Regional Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100329000121 | NC | Practitioner - Physician Assistant | 2769518851 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4371 | NY | MD | Peer Specialist |
| 103674 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Capital Region Orthopaedic Associates, PC | Orthopaedic Surgery | Past | Accepting new patients |
| Memorial Hospital, Albany, N.Y. | Past | Accepting new patients | |
| Firsthealth of the Carolinas, Inc Dba Firsthealth Weight Management Clinic | Past | Accepting new patients |
Interoperability endpoints
- kevinslater@fhss.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 103674 | NC | Yes |
Addresses
Primary practice location
5 First Village Drive
Pinehurst, NC 28374
Mailing address
5 Firstvillage Drive
PO Box 2000
Pinehurst, NC 28374
Phone (910) 295-6831
Other providers in Pinehurst, NC
- Kenya Singley
- Shannon Louette Skaug
- Scott D Skibo
- Joseph M Skladany
- Zoila Dana Slappe
- Van Slaughter Jr.
- Gwendolyn Sledge
- Sleepmed Therapies Inc.
- Daisy Bosque Smiley
- Anyah Smith
All providers in Pinehurst, NC · Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.