NPIMap

Individual provider Active NPI

Kaitlyn Reti, D.O.

  • Emergency Medicine Physician
  • Southport, NC
National Provider Identifier
1841614476
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2016-01465 Issued in NC
Practice address
924 N Howe St
Southport, NC 28461-3099
Phone
(910) 457-3800
NPI assigned
Feb 18, 2014
Last updated
May 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X 2016-01465 NC Primary

Addresses

Primary practice location

924 N Howe St
Southport, NC 28461-3099

Mailing address

5103 Northcreek Rd
Wilmington, NC 28409-4119
Phone (908) 377-6286

Other practice location 1

300 W 27th St
Lumberton, NC 28358-3075
Phone (910) 671-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20160823000423 NC Practitioner - Emergency Medicine 1052606506 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robeson Emergency Physicians PLLCGroup PAC ID 3870846934, 29 clinicians
J. Arthur Dosher Memorial HospitalGroup PAC ID 8921910324, shared by 6 NPIs, 53 clinicians

Practice addresses (Care Compare)

300 W 27TH St
Lumberton, NC 28358-3075
Phone (910) 671-5000

924 N Howe St
Southport, NC 28461-3038
Phone (910) 457-3827

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
85.58
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2016-01465NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
J. Arthur Dosher Memorial Hospital Current Accepting new patients
J. Arthur Dosher Memorial Hospital CurrentSince Apr 19, 2024 Accepting new patients
J. Arthur Dosher Memorial Hospital CurrentSince Oct 10, 2025 Accepting new patients
J Arthur Dosher Memorial Hospital CurrentSince Apr 19, 2024 Accepting new patients
Robeson Emergency Physicians, PLLC Emergency Medicine CurrentSince Aug 5, 2018 Accepting new patients

Locations

300 W 27th St
Lumberton, NC 28358
Phone (910) 671-5000

821 N Atlantic Ave
Southport, NC 28461
Phone (910) 457-3827

924 N Howe St
Southport, NC 28461
Phone (910) 457-3800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 5

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 6

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": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1841614476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5103 NORTHCREEK RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284094119",
            "telephone_number": "908-377-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 N HOWE ST",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284613099",
            "telephone_number": "910-457-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 W 27th St",
            "address_purpose": "LOCATION",
            "city": "Lumberton",
            "state": "NC",
            "postal_code": "283583075",
            "country_code": "US",
            "telephone_number": "910-671-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RETI",
        "first_name": "KAITLYN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-18",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2016-01465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, NC

Sources for this page

Verify at the official NPI Registry.