SHELLY WARREN DARTY (NPI# 1013990712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013990712 |
| Entity Type | Individual |
| Full Name | SHELLY WARREN DARTY |
| Credential | PAC |
| Practice Address |
861 Old Winston Rd Kernersville NC 27284-7140 |
| Mailing Address |
607 Idol St High Point NC 27262-7804 |
| Practice Telephone | 3368022300 |
| Practice Fax Number | 3368022301 |
| Mailing Telephone | 3368022400 |
| Mailing Fax Number | 3368022001 |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2009-05-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
102585 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | AETNA | 7057773 | 01 |
| NC | MEDCOST | D7935 | 01 |
| Street Address |
861 OLD WINSTON RD |
| City | KERNERSVILLE |
| State | NC |
| Zip Code | 27284-7140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922434307 | Cornerstone Health Care, LLC | Internal Medicine | 861 Old Winston Rd, Suite 101, Kernersville, NC 27284-7140 | 2013-09-18 |
| 1417299603 | Brandi Foster Jordan | Nurse Practitioner | 861 Old Winston Rd, Kernersville, NC 27284-7140 | 2013-03-26 |
| 1740553429 | Amanda Allen Mounce | Nurse Practitioner | 861 Old Winston Rd, Suite 103, Kernersville, NC 27284-7140 | 2012-02-11 |
| 1487879177 | Cornerstone Health Care, Pa | Pediatrics | 861 Old Winston Rd, Suite 103, Kernersville, NC 27284 | 2007-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013549047 | Katie Lee Sherman | Student in an Organized Health Care Education/Training Program | 9372 Pumpkin Ridge Rd, Kernersville, NC 27284 | 2020-02-07 |
| 1861049231 | Bethany Medical Center | Internal Medicine | 975 Hwy 66 S, Kernersville, NC 27284 | 2019-08-21 |
| 1114490810 | Lindsey Sarvis | Social Worker | 2301 Lake Shore Reserve Court, Kernersville, NC 27284 | 2019-01-04 |
| 1073091088 | Gastroenterology Associates of The Piedmont, P.a. | Internal Medicine | 445 Pineview Dr Ste 200b, Kernersville, NC 27284 | 2018-08-01 |
| 1942786629 | Brea Anjanee' Washington | Nurse Practitioner | 1635 Nc 66 South, Suite 145, Kernersville, NC 27284 | 2018-07-16 |
| 1992216246 | Charley Elizabeth Cummings | Physician Assistant | 1635 Nc-66, Kernersville, NC 27284 | 2017-10-13 |
| 1902324304 | Susan Marie Garcia | Counselor | 822 Old Winston Road, Suite 5, Kernersville, NC 27284 | 2017-09-06 |
| 1871034603 | Ljp Lab LLC | Clinical Medical Laboratory | 495 Arbor Hill Rd Ste S, Kernersville, NC 27284 | 2017-03-13 |
| 1912446253 | Knew Era Consulting | Counselor | 335 Creekview Drive, Kernersville, NC 27284 | 2017-02-20 |
| 1144686593 | Amber Moore | Counselor | 822 Old Winston Rd, Suite 5, Kernersville, NC 27284 | 2016-01-14 |
| Find all providers in zip 27284 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992216246 | Charley Elizabeth Cummings | Physician Assistant | 1635 Nc-66, Kernersville, NC 27284 | 2017-10-13 |
| 1053849497 | Eric Robert Bifolck | Physician Assistant | 210 N Main St Ste 144, Kernersville, NC 27284-4003 | 2017-05-30 |
| 1386036796 | Matthew Kyle Tucker | Physician Assistant | 1710 Kernersville Medical Pkwy Ste 202, Kernersville, NC 27284-7156 | 2015-02-21 |
| 1215983044 | Crystal S Rose | Physician Assistant | 280 Broad St Ste A, Kernersville, NC 27284 | 2006-05-25 |
| 1790736064 | Brandy L Embry | Physician Assistant | 794 S Main St Ste B, Kernersville, NC 27284-4074 | 2006-05-12 |
| 1942250105 | Jason R Heggerick | Physician Assistant | 445 Pineview Drive, Suite 220, Kernersville, NC 27284 | 2006-05-10 |
| 1992331235 | Jennifer Lynn Pyle | Physician Assistant | 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 | 2020-03-18 |
| 1376102111 | Sarah Anderson | Physician Assistant | 445 Pineview Dr Ste 220, Kernersville, NC 27284-3818 | 2019-06-06 |
| 1316429798 | Thomas Scott Steele Jr. | Physician Assistant | 1730 Kernersville Medical Pkwy Ste 204, Kernersville, NC 27284-7198 | 2018-09-03 |
| 1215420658 | Caroline Cloud Jones | Physician Assistant | 240 Broad St, Kernersville, NC 27284 | 2018-06-11 |
| Find all providers in KERNERSVILLE | ||||
| City | KERNERSVILLE |
| Zip Code | 27284 |
Please comment or provide details below to improve the information on SHELLY WARREN DARTY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.