Kelly Pate Nguyen, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

201652 Issued in NC

Practice address

1110 SE Cary Pkwy
Suite 206
Cary, NC 27518-7420

Phone

(919) 463-1101

Fax

(919) 463-1110

NPI assigned

Jun 15, 2007

Last updated

Apr 14, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kelly Jean Pate Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Wake Neurology PLLC

  • Neurology Physician
  • Cary, NC
  • NPI 1669547766
  NPD (past)

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428969600000",
    "number": "1801091343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 SE CARY PKWY",
            "address_2": "SUITE 206",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187420",
            "telephone_number": "919-463-1101",
            "fax_number": "919-463-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 SE CARY PKWY",
            "address_2": "SUITE 206",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187420",
            "telephone_number": "919-463-1101",
            "fax_number": "919-463-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KELLY",
        "middle_name": "PATE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2015-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "201652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7003970",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "PATE",
            "middle_name": "JEAN",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Luong Hoc Ngo, PT
• Amanda Nguyen, DDS
• Brittany Ngoc Nguyen
• Brooke Prestridge Nguyen, M.D.
• Hieu Minh Tri Nguyen, DMD
• Kha Dinh Nguyen, PHARMD
• Megan M Nguyen, DDS
• Phillip Nam Nguyen, MD
• Grace Nichols
• Monica A Nichols, MA

• Nurse Practitioner in Cary, NC
• Providers in Cary, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.