Kenneth Debarth, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

101944 Issued in NC

Practice address

4923 S Croatan Hwy
Nags Head, NC 27959-9709

Phone

(252) 261-8040

Fax

(252) 441-7041

NPI assigned

May 19, 2006

Last updated

Feb 18, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203292800000",
    "number": "1811941495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1134 N ROAD ST",
            "address_2": "BLDG.9",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093365",
            "telephone_number": "252-338-9451",
            "fax_number": "252-338-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4923 S CROATAN HWY",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279599709",
            "telephone_number": "252-261-8040",
            "fax_number": "252-441-7041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBARTH",
        "first_name": "KENNETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2008-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "101944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Continuum II Home Health & Hospice, Inc. (Continuum Home Care of Outer Banks)
• Croatan Family Medicine, P.C.
• Jill Ann Curry, MA, LCMHCA, NCC
• Dare County Schools
• Denise Elaine De Pedro, NBC-HWC
• Leslie Schmidt Deligio, DNP, FNP-C
• Judy Ann Demooy, MSW, LCSW
• Erin Kathryn Devanney, FNP-C
• Elizabeth Dotterer Dixon, MS, RDN, LDN
• William Milnor Downing VI, D.D.S.

• Physician Assistant in Nags Head, NC
• Providers in Nags Head, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2008; 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.