Kelly Blankenship Spry, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

103658 Issued in NC

Practice address

3623 Latrobe Dr Ste 216
Charlotte, NC 28211-2117

Phone

(704) 332-1291

Fax

(704) 926-1832

NPI assigned

Aug 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

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, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Rowan Medical Center Hospital, Salisbury, NC, CCN 340015
• Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183
• North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  Medicare reassignment Care Compare group NPD
• Mecklenburg Radiology Associates, P.a.

  • Diagnostic Radiology Physician
  • Charlotte, NC
  • NPI 1295790657
  Medicare reassignment
• Mid-Atlantic Emergency Medical Associates, PLLC

  • Emergency Medicine Physician
  • Charlotte, NC
  • NPI 1073562757
  NPD (past)

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

• North Carolina Baptist Hospital

  • Psychiatric Hospital Unit
  • Winston Salem, NC
  • NPI 1063480531
  Care Compare affiliation
• North Carolina Baptist Hospital

  • Rehabilitation Hospital Unit
  • Winston Salem, NC
  • NPI 1114995677
  Care Compare affiliation
• North Carolina Baptist Hospital

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1144211301
  Care Compare affiliation
• North Carolina Baptist Hospital

  • Clinical Medical Laboratory
  • Winston Salem, NC
  • NPI 1609162098

  Hospital

  Care Compare affiliation
• North Carolina Baptist Hospital

  • Pediatric Adolescent Medicine Physician
  • Winston Salem, NC
  • NPI 1912179219

  Hospital

  Care Compare affiliation
• Novant Health Rowan Medical Center LLC

  • General Acute Care Hospital
  • Salisbury, NC
  • NPI 1508843566
  Care Compare affiliation
• The Presbyterian Hospital

  • General Acute Care Hospital
  • Huntersville, NC
  • NPI 1346291309
  Care Compare affiliation

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1982717484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 221249",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282221249",
            "telephone_number": "704-332-1291",
            "fax_number": "704-926-1832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3623 LATROBE DR STE 216",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112117",
            "telephone_number": "704-332-1291",
            "fax_number": "704-926-1832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271570001",
            "country_code": "US",
            "telephone_number": "336-716-7243",
            "fax_number": "336-716-7432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1249 15th St",
            "address_2": "Suite 4093",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257013662",
            "country_code": "US",
            "telephone_number": "304-691-8714",
            "fax_number": "304-691-8591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPRY",
        "first_name": "KELLY",
        "middle_name": "BLANKENSHIP",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "103658",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "1973",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0251PA",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00247717",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Charlotte, NC
• Providers in Charlotte, 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 Jun 5, 2026; 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.