NPIMap

Individual provider Active NPI

Kathryn Hazel Whitehead, PA-C

  • Physician Assistant
  • Clyde, NC
National Provider Identifier
1831647510
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-16685 Issued in NC
Practice address
490 Hospital Dr
Clyde, NC 28721-8026
Phone
(828) 246-6372
Fax
(828) 246-6371
NPI assigned
Sep 12, 2016
Last updated
Sep 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-16685 NC Primary
Physician Assistant 363A00000X PA60703191 WA

Addresses

Primary practice location

490 Hospital Dr
Clyde, NC 28721-8026

Mailing address

490 Hospital Dr
Clyde, NC 28721-8026
Phone (828) 246-6372

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161209001762 WA Practitioner - Physician Assistant 4385924224 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Indiana University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Care Network, PLLCGroup PAC ID 0446142046, 124 clinicians

Practice addresses (Care Compare)

1610 Grover St
Lynden, WA 98264-1539

3500 Orchard PL
Bellingham, WA 98225-1749
Phone (360) 671-3900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
54656CAMDPharmacist
PA60703191WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Network PLLC CurrentSince Jan 16, 2023 Accepting new patients
Cep America LLC CurrentSince Nov 3, 2022 Accepting new patients
Family Care Network PLLC CurrentSince Jan 16, 2023 Accepting new patients
Cep America-California CurrentSince Aug 1, 2017 Accepting new patients
Cep America LLC CurrentSince Nov 3, 2022 Accepting new patients
Family Care Network PLLC PastSince Dec 13, 2022 Accepting new patients
Family Care Network PLLC Past Accepting new patients

Locations

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

21601 76th Ave W
Edmonds, WA 98026
Phone (425) 640-4000

1610 Grover St
Ste D1
Lynden, WA 98264
Phone (360) 312-3785

Interoperability endpoints

  • Direct secure messaging: kstewart19779@direct.fcn.net

Organizations & group practices 10

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1831647510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 HOSPITAL DR",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287218026",
            "telephone_number": "828-246-6372",
            "fax_number": "828-246-6371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 HOSPITAL DR",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287218026",
            "telephone_number": "828-246-6372",
            "fax_number": "828-246-6371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "KATHRYN",
        "middle_name": "HAZEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-16685",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60703191",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clyde, NC

Sources for this page

Verify at the official NPI Registry.