KENNETH PELLETIER (NPI# 1265488662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265488662 |
| Entity Type | Individual |
| Full Name | KENNETH PELLETIER |
| Credential | PA-C |
| Practice Address |
3404 Wake Forest Rd Ste 201 Raleigh NC 27609-7341 |
| Practice Telephone | 9192561511 |
| Practice Fax Number | 9192561530 |
| Mailing Telephone | 9192561511 |
| Mailing Fax Number | 9192561530 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2010-08-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
102579 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184748014 | Kenneth R. Pelletier | Clinical Neuropsychologist | 5 Country Oak Ln, Alamo, CA 94507-2854 | 2007-03-17 |
| Street Address |
3404 WAKE FOREST RD STE 201 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27609-7341 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467455832 | Jon Kolkin | Orthopaedic Surgery | 3404 Wake Forest Rd, Ste 303, Raleigh, NC 27609-7341 | 2005-05-31 |
| 1891283073 | Regional Anesthesia, Pllc | Specialist | 3404 Wake Forest Rd, Raleigh, NC 27609-7340 | 2018-04-24 |
| 1023517745 | Melissa Jo Peterson | Nurse Practitioner | 3404 Wake Forest Rd, Raleigh, NC 27609-7340 | 2018-02-08 |
| 1972054211 | Claire Gere Reynolds | Nurse Practitioner | 3404 Wake Forest Rd, 202, Raleigh, NC 27609-7340 | 2016-10-21 |
| 1477920247 | Jaclyn White | Nurse Practitioner | 3404 Wake Forest Rd, Suite 302, Raleigh, NC 27609-7340 | 2015-08-27 |
| 1790160745 | Catherine Frances Sellers | Nurse Practitioner | 3404 Wake Forest Rd, Mob 7, Lower Level, Raleigh, NC 27609-7340 | 2015-07-20 |
| 1093057028 | Stephanie Nicole Roberts | Registered Nurse | 3404 Wake Forest Rd, St 200, Raleigh, NC 27609-7340 | 2013-03-15 |
| 1942558705 | Meaghan Thomas | Occupational Therapy Assistant | 3404 Wake Forest Rd, Suite 303, Raleigh, NC 27609-7340 | 2012-08-27 |
| 1306116611 | Private Diagnostic Clinic, Pllc | Obstetrics & Gynecology | 3404 Wake Forest Rd, Suite 200, Raleigh, NC 27609-7340 | 2012-01-03 |
| 1477834349 | Brittaney Swift Wolfe | Nurse Practitioner | 3404 Wake Forest Rd, Suite 203, Raleigh, NC 27609-7340 | 2011-09-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184235582 | Choice Service Solutions LLC | In Home Supportive Care | 5300 Six Fox Rd Siite205, Raleigh, NC 27609 | 2020-08-11 |
| 1003426073 | Rosana Oba -rovira | Registered Nurse | 5300 Six Fox Road, Suite 205, Raleigh, NC 27609 | 2020-08-05 |
| 1821612706 | Helen Alexandra Bonner | Physical Medicine & Rehabilitation | Hey Clinic Pa, 3320 Wake Forest Road Ste 450, Raleigh, NC 27609 | 2020-06-05 |
| 1215423579 | Appiah Nana Larbi | Social Worker | Easter Seals Ucp 4000 Wake Forest Rd Ste 200, Raleigh, NC 27609 | 2018-07-10 |
| 1215423777 | Broadway Home Care LLC | In Home Supportive Care | 107 Windel Dr Ste 105, Raleigh, NC 27609 | 2018-07-09 |
| 1275027948 | Lacey Allene Cottingham | Social Worker | 312 W Millbrook Rd Ste 129, Raleigh, NC 27609 | 2018-06-18 |
| 1447748819 | Integrated Dermatology of North Raleigh, Pllc | Dermatology | 3809 Computer Dr Ste 200, Raleigh, NC 27609 | 2018-05-01 |
| 1902325418 | Naomi Christine Askew | Nurse Practitioner | 3400 Wake Forest Drive, Bldg 9, Bldg #9, 4th Floor, Raleigh, NC 27609 | 2017-09-15 |
| 1962929679 | Alexia Montague | Social Worker | 1306 Paddock Drive Suite E-100, Raleigh, NC 27609 | 2017-08-23 |
| 1730602236 | Chantel Washington-mbuthia | Counselor | 1100 Logger Ct. Ste C100, Heartfelt Alternative Inc, Raleigh, NC 27609 | 2017-07-18 |
| Find all providers in zip 27609 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407170079 | Stephanie Solosko | Physician Assistant | 8238 Primanti Blvd, Raleigh, NC 27612-7413 | 2010-03-25 |
| 1386817203 | Katherine Noland Sherron | Physician Assistant | 10941 Raven Ridge Rd Ste 103, Raleigh, NC 27614-6487 | 2008-04-11 |
| 1053430652 | Sharon Ann Mowrey | Physician Assistant | 3333 Clandon Park Dr, Raleigh, NC 27613-8841 | 2007-03-28 |
| 1306907043 | Roshni Patel Mapp | Physician Assistant | Duke Thoracic Surgery of Raleigh, 3404 Wake Forest Rd, Suite 201, Raleigh, NC 27609 | 2006-12-13 |
| 1437186152 | Rita Marie Langworth-brewer | Physician Assistant | 3737 Glenwood Ave, Raleigh, NC 27612-5515 | 2006-06-27 |
| 1033716634 | Sarah Petty Butler | Physician Assistant | 5838 Six Forks Rd Ste 100, Raleigh, NC 27609-3893 | 2020-10-06 |
| 1043829534 | Samantha Talbot Brown | Physician Assistant | 4509 Creedmoor Rd Ste 201, Raleigh, NC 27612-3813 | 2020-07-30 |
| 1093361859 | Kirsten Sinclair Renz | Physician Assistant | 3320 Wake Forest Rd Ste 450, Raleigh, NC 27609-7300 | 2019-08-16 |
| 1265087076 | Lauren Wells Queen | Physician Assistant | 11200 Governor Manly Way Ste 309, Raleigh, NC 27614-7375 | 2019-08-08 |
| 1730734211 | Shea Tryon Whittaker | Physician Assistant | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2019-08-02 |
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| 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.