Brittainy Raelena Edwards Kildow, PT
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Beulaville, NC
NPI 1932291010 · NPPES record last updated Aug 14, 2014
Key facts
- NPI
- 1932291010
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- 9424 (NC)
- Practice address
- 159 Crossover Rd
Beulaville, NC 28518-8801 - Phone
- (910) 298-6455
- Fax
- (910) 298-6405
- NPI assigned
- Sep 28, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Edwards and Associates Physical Therapy
Practice addresses (Care Compare)
159 Crossover Rd
Beulaville, NC 28518-8801
Phone (910) 298-6455
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050520000877 | NC | Practitioner - Physical Therapist in Private Practice | 4981645793 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9424 | NC | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edwards and Associates Physical Therapy | Physical Medicine & Rehabilitation | Current |
Accepting new patients |
| Carolina Rehabilitation Inc | Physical Medicine & Rehabilitation | Current |
Accepting new patients |
Locations
159 Crossover Rd
Beulaville, NC 28518
Phone (910) 298-6455
20 Medical Campus Dr NW
Ste 204
Supply, NC 28462
Phone (910) 612-1002
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 9424 | NC | Yes |
Addresses
Primary practice location
159 Crossover Rd
Beulaville, NC 28518-8801
Mailing address
305 S Front St
Wilmington, NC 28401-4416
Phone (910) 385-7149
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7211906 | Medicaid | NC |
Other providers in Beulaville, NC
- Coastal Carolina Respiratory Services, Inc
- Craig a. Marva, DMD, PLLC
- Christopher Thad Dixon
- Bridget Renee Eason
- Edwards and Associates Physical Therapy
- Megan Katherine Eldridge
- Kendall Sorrell English
- Dajour Farland
- Teresa Fisher
- Susan Flowers Frederick
All providers in Beulaville, NC · Physical Medicine & Rehabilitation Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.