Active NPI
Kelsey Marie Quaile, PA-C
- Physician Assistant
- Burlington, NC
National Provider Identifier
1972242840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-12246
- Practice address
- 3804 S Church St
Burlington, NC 27215-9134 - Phone
- (336) 524-0304
- NPI assigned
- May 31, 2022
- 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 | 0010-12246 | NC | Primary |
Addresses
Primary practice location
3804 S Church St
Burlington, NC 27215-9134
Mailing address
334 Slate Dr
Gibsonville, NC 27249-2867
Phone (336) 354-8827
Other practice location 1
3940 Arrowhead Blvd Ste 270
Mebane, NC 27302-7637
Phone (919) 563-0202
Other practice location 2
530 W Webb Ave
Burlington, NC 27217-3706
Phone (336) 228-8316
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-12246 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Burlington Pediatrics PA | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Burlington, NC
- NPI 1841378296
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653955200000",
"number": "1972242840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "334 SLATE DR",
"city": "GIBSONVILLE",
"state": "NC",
"postal_code": "272492867",
"telephone_number": "336-354-8827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3804 S CHURCH ST",
"city": "BURLINGTON",
"state": "NC",
"postal_code": "272159134",
"telephone_number": "336-524-0304"
}
],
"practiceLocations": [
{
"address_1": "3940 Arrowhead Blvd Ste 270",
"address_purpose": "LOCATION",
"city": "Mebane",
"state": "NC",
"postal_code": "273027637",
"country_code": "US",
"telephone_number": "919-563-0202",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "530 W Webb Ave",
"address_purpose": "LOCATION",
"city": "Burlington",
"state": "NC",
"postal_code": "272173706",
"country_code": "US",
"telephone_number": "336-228-8316",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "QUAILE",
"first_name": "KELSEY",
"middle_name": "MARIE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-31",
"last_updated": "2022-05-31",
"certification_date": "2022-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-12246",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Burlington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.