Individual provider Active NPI

Michelle Kidder Fegeley, PA-C

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1992032296
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-01978 Issued in NC
Practice address
11200 Governor Manly Way Ste 309
Raleigh, NC 27614-7375
Phone
(919) 562-9410
Fax
(919) 562-2948
NPI assigned
Nov 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 0010-01978 NC Primary

Addresses

Primary practice location

11200 Governor Manly Way Ste 309
Raleigh, NC 27614-7375

Mailing address

PO Box 1107
Wake Forest, NC 27588-1107
Phone (919) 562-9410

Other practice location 1

103 Professional Park Ste A
Oxford, NC 27565-2581
Phone (919) 562-9410

Other practice location 2

6602 Knightdale Blvd Ste 310
Knightdale, NC 27545-6526
Phone (919) 562-9410

Other practice location 3

200 W Parkview Dr Ste B
Henderson, NC 27536-5958
Phone (919) 562-9410

Other practice location 4

2605 Blue Ridge Rd Ste 320
Raleigh, NC 27607-6475
Phone (919) 562-9410

Other names 1

  • Michelle Kidder Former name

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
I20091217000176 NC Practitioner - Physician Assistant 6800936188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Orthopaedic Specialists of North Carolina, P.a.Group PAC ID 7810974375, 49 clinicians

Practice addresses (Care Compare)

11221 Galleria Ave
Suite 101
Raleigh, NC 27614-8137
Phone (919) 562-9410

Hospital & facility affiliations

  • Rex Hospital Hospital, Raleigh, NC, CCN 340114
  • Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069
  • Granville Health Systems Hospital, Oxford, NC, CCN 340127

Merit-based Incentive Payment System (MIPS)

Final score
83.06 of 100Reported as group
Quality
61.01
Promoting interoperability
100
Improvement activities
40
Cost
82.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Specialists of North Carolina, P.a. CurrentSince Feb 6, 2012 Accepting new patients
Central Emergency Physicians, PLLC PastSince Jan 26, 2020 Accepting new patients

Locations

200 W Parkview Dr
#B
Henderson, NC 27536

6602 Knightdale Blvd
Ste 310
Knightdale, NC 27545

103 Professional Park
Ste A
Oxford, NC 27565
Phone (919) 693-7108

5838 Six Forks Rd
Ste 100
Raleigh, NC 27609

11200 Governor Manly Way
Ste 309
Raleigh, NC 27614
Phone 9195629410247

11221 Galleria Ave
#101
Raleigh, NC 27614
Phone 9195629410213

1936 Golden Spur Ln
Wendell, NC 27591

Interoperability endpoints

  • Direct secure messaging: mfegeley109314@direct.medicine.duke.edu
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: michelle.fegeley.1@12529.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 4

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": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1992032296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1107",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275881107",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-2948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 GOVERNOR MANLY WAY STE 309",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276147375",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-2948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Professional Park Ste A",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "NC",
            "postal_code": "275652581",
            "country_code": "US",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-2948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6602 Knightdale Blvd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Knightdale",
            "state": "NC",
            "postal_code": "275456526",
            "country_code": "US",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-2948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 W Parkview Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NC",
            "postal_code": "275365958",
            "country_code": "US",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-2948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2605 Blue Ridge Rd Ste 320",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276076475",
            "country_code": "US",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-2948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEGELEY",
        "first_name": "MICHELLE",
        "middle_name": "KIDDER",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "KIDDER",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.