Kelly Elizabeth Trawick

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-12421 Issued in NC

Practice address

620 Dr Calvin Jones Hwy Ste 212
Wake Forest, NC 27587-3108

Phone

(919) 761-5678

NPI assigned

Mar 18, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rex Hospital Hospital, Raleigh, NC, CCN 340114

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: ktrawick737952@direct.unc.nchie.net
• Direct secure messaging: kellytrawick@huc.allscriptsdirect.net

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.

• North Carolina MG, LLC

  • Hospitalist Physician
  • Raleigh, NC
  • NPI 1215741640
  Medicare reassignment Care Compare group
• Rex Hospital Inc

  • Cardiovascular Disease Physician
  • Raleigh, NC
  • NPI 1972939643
  NPD (past)

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

• Rex Hospital Inc.

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1497797088
  Care Compare affiliation

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1841949823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 DR CALVIN JONES HWY STE 212",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873108",
            "telephone_number": "919-761-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 DR CALVIN JONES HWY STE 212",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873108",
            "telephone_number": "919-761-5678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4207 Lake Boone Trl Ste 210",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276076685",
            "country_code": "US",
            "telephone_number": "919-784-7874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAWICK",
        "first_name": "KELLY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-18",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ktrawick737952@direct.unc.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "4207 Lake Boone Trl Ste 210",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276076685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Therese Torres, MS, CCC-SLP
• Deborah M Townsend, RPH
• Scott A Townsend, RPH
• Tran M. Nguyen, DDS, PA
• Kerry Elizabeth Drury Traverso, MD
• Karyn Traxler
• Jennifer M Trella, MD
• Michael Trenk, LMHC
• TRG Health Care Systems LLC
• Triangle Diabetic Supply

• Physician Assistant in Wake Forest, NC
• Providers in Wake Forest, 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 Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.