Individual provider Active NPI

Kennedy Selby, PA-C

  • Physician Assistant
  • Wilmington, NC
National Provider Identifier
1932076239
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-15480 Issued in NC
Practice address
3787 Shipyard Blvd
Wilmington, NC 28403-6148
Phone
(910) 332-3800
NPI assigned
Oct 21, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-15480 NC Primary

Addresses

Primary practice location

3787 Shipyard Blvd
Wilmington, NC 28403-6148

Mailing address

PO Box 5105
Belfast, ME 04915-5100
Phone (910) 332-3800

Other practice location 1

2501 N Blackwelder Ave
Oklahoma City, OK 73106-1402
Phone (405) 208-5000

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
I20260206000201 NC Practitioner - Physician Assistant 2860971298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Practice addresses (Care Compare)

3787 Shipyard Blvd
Wilmington, NC 28403-6148
Phone (910) 332-3800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-15480NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA Physician Assistant CurrentSince Jan 5, 2026 Accepting new patients
Emergeortho PA CurrentSince Jan 5, 2026 Accepting new patients

Locations

2000 Brabham Ave
Ste 100
Jacksonville, NC 28546

1168 E Cutlar Crossing
Leland, NC 28451
Phone (814) 836-8113

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

3787 Shipyard Blvd
Wilmington, NC 28403
Phone (910) 341-2444

2716 Ashton Dr
Wilmington, NC 28412
Phone (910) 332-1534

8115 Market St
Ste 108
Wilmington, NC 28411
Phone (910) 763-2361

Interoperability endpoints

  • Direct secure messaging: kennedy.selby.1@847.direct.athenahealth.com

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.

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": "1761004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1932076239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5105",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049155100",
            "telephone_number": "910-332-3800",
            "fax_number": "910-241-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3787 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036148",
            "telephone_number": "910-332-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 N Blackwelder Ave",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731061402",
            "country_code": "US",
            "telephone_number": "405-208-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELBY",
        "first_name": "KENNEDY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-21",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-15480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.