Individual provider Active NPI

Margaret Elaine Kelley, PA-C

  • Physician Assistant
  • Holly Springs, NC
National Provider Identifier
1841612900
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-04760 Issued in NC
Practice address
850 S Main St
Holly Springs, NC 27540-8906
Phone
(919) 784-7093
NPI assigned
Jan 9, 2014
Last updated
May 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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 0010-04760 NC Primary
Medical Physician Assistant 363AM0700X NU

Addresses

Primary practice location

850 S Main St
Holly Springs, NC 27540-8906

Mailing address

1135 Carthage St
Sanford, NC 27330-4162
Phone (919) 744-2109

Other practice location 1

1135 Carthage St
Sanford, NC 27330-4162
Phone (919) 744-2109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140320002359 NC Practitioner - Physician Assistant 0941431605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians

Practice addresses (Care Compare)

4420 Lake Boone TRL
Raleigh, NC 27607-7505

850 S Main St
Holly Springs, NC 27540-8906
Phone (984) 215-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-04760NCMDPhysician Assistant

Organizations & group practices 1

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 1

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": "1389225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1841612900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 CARTHAGE ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304162",
            "telephone_number": "919-744-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S MAIN ST",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275408906",
            "telephone_number": "919-784-7093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1135 Carthage St",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "NC",
            "postal_code": "273304162",
            "country_code": "US",
            "telephone_number": "919-744-2109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "MARGARET",
        "middle_name": "ELAINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-09",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04760",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Springs, NC

Sources for this page

Verify at the official NPI Registry.