| Kim Kerry Neely, PAC | |
|
2001 Van Haven Dr, Statesville, NC 28625-4342 | |
| (704) 942-7922 | |
| (704) 828-8248 |
| Full Name | Kim Kerry Neely |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 2001 Van Haven Dr, Statesville, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912084013 | NPI | - | NPPES |
| 561976679 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 102318 (North Carolina) | Primary |
| Entity Name | Bomray Medical Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013974864 PECOS PAC ID: 6507847068 Enrollment ID: O20040528001186 |
| Entity Name | Longevity Accountable Care, PA |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396584454 PECOS PAC ID: 0840734034 Enrollment ID: O20240718000268 |
| Mailing Address | Practice Location Address |
|---|---|
| Kim Kerry Neely, PAC 12824 District South Dr Apt 6414, Charlotte, NC 28277-5221 Ph: (704) 996-4973 | Kim Kerry Neely, PAC 2001 Van Haven Dr, Statesville, NC 28625-4342 Ph: (704) 942-7922 |
Summer Elizabeth Lackey, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 705 Gaither Rd, Statesville, NC 28625 Phone: 704-871-1155 Fax: 704-872-2484 |
Helena Bui, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1405 Fern Creek Dr, Statesville, NC 28625 Phone: 704-659-7866 |
Ms. Bridgette Ann Cooke, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 340 Signal Hill Dr Ste C, Statesville, NC 28625 Phone: 704-871-8999 |
Mrs. Allyson M. Savery, PA-C, M.S. Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 276 Old Mocksville Rd, Suite 100, Statesville, NC 28625 Phone: 704-883-8660 Fax: 704-883-8661 |
Jill Suzanne Calhoun, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 738 Bryant St Ste A, Statesville, NC 28677 Phone: 704-873-1189 Fax: 704-873-1116 |
Ms. Kacie Miller Teeter, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 310 Davie Ave, Statesville Family Practice, Statesville, NC 28677 Phone: 704-873-3269 Fax: 704-871-8159 |
Jared Carter, PAC Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 1540 E Broad St Ste B, Statesville, NC 28625 Phone: 704-380-6900 Fax: 704-380-6901 |