Individual provider Active NPI

Kaley Everhart Cucci, NP

  • Pediatrics Physician
  • Thomasville, NC
National Provider Identifier
1831721158
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5012814 Issued in NC
Practice address
200 Arthur Dr
Thomasville, NC 27360-6275
Phone
(336) 475-2348
NPI assigned
Feb 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5012814 NC Primary

Addresses

Primary practice location

200 Arthur Dr
Thomasville, NC 27360-6275

Mailing address

620 Apache Dr
Winston Salem, NC 27107-6164
Phone (336) 239-5327

Other practice location 1

210 School Rd
Trinity, NC 27370-9409
Phone (336) 861-2348

Other practice location 2

6329 Unity St Ste I
Thomasville, NC 27360-7186
Phone (336) 474-2348

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5012814NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thomasville-Archdale Pediatrics, PLLC Pediatrics CurrentSince Feb 9, 2020 Accepting new patients
Thomasville/Archdale Pediatrics PLLC PastSince Feb 9, 2020 Accepting new patients

Locations

6329 Unity St
Ste I
Thomasville, NC 27360
Phone (336) 474-2348

6329 Unity St
Thomasville, NC 27360
Phone (336) 474-2348

200 Arthur Dr
Thomasville, NC 27360
Phone (336) 475-2348

210 School Rd
Trinity, NC 27370
Phone (336) 861-2348

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1831721158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 APACHE DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271076164",
            "telephone_number": "336-239-5327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ARTHUR DR",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273606275",
            "telephone_number": "336-475-2348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 School Rd",
            "address_purpose": "LOCATION",
            "city": "Trinity",
            "state": "NC",
            "postal_code": "273709409",
            "country_code": "US",
            "telephone_number": "336-861-2348",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6329 Unity St Ste I",
            "address_purpose": "LOCATION",
            "city": "Thomasville",
            "state": "NC",
            "postal_code": "273607186",
            "country_code": "US",
            "telephone_number": "336-474-2348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUCCI",
        "first_name": "KALEY",
        "middle_name": "EVERHART",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "5012814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; 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.