Active NPI
Kayleigh Surendra, PA-C
- Physician Assistant
- Holly Springs, NC
National Provider Identifier
1851643670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-04330
- Practice address
- 126 Grand Hill PL
Holly Springs, NC 27540-4416 - Phone
- (919) 285-2138
- NPI assigned
- Oct 3, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-04330 | NC | Primary |
Addresses
Primary practice location
126 Grand Hill PL
Holly Springs, NC 27540-4416
Mailing address
200 Olive Field Dr
Holly Springs, NC 27540-6215
Phone (443) 315-3785
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)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760918400000",
"number": "1851643670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 OLIVE FIELD DR",
"city": "HOLLY SPRINGS",
"state": "NC",
"postal_code": "275406215",
"telephone_number": "443-315-3785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "126 GRAND HILL PL",
"city": "HOLLY SPRINGS",
"state": "NC",
"postal_code": "275404416",
"telephone_number": "919-285-2138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SURENDRA",
"first_name": "KAYLEIGH",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-03",
"last_updated": "2025-10-20",
"certification_date": "2025-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-04330",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holly Springs, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.