Kenyon L Draper (NPI# 1144573197, PAC ID# 4587899513) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1144573197 |
| PAC ID by PECOS | 4587899513 |
| Professional Enrollment ID | I20131029002040 |
| Full Name | Kenyon L Draper |
| Organization Legal Name | HOLSTON MEDICAL GROUP PC |
| Address |
3500 Mount Holly Huntersville Rd Suite B Charlotte NC 28216-8644 |
| Phone Number | 4233437028 |
| Gender | M |
| Graduation Year | 2011 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 8224935754 |
| Number of Group Practice Members | 229 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 340183 | NOVANT HEALTH HUNTERSVILLE MEDICAL CENTER |
| 340053 | NOVANT HEALTH PRESBYTERIAN MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 3500 Mount Holly Huntersville Rd, Suite B, Charlotte, NC 28216-8644 | 4233437028 | HOLSTON MEDICAL GROUP PC |
| Organization Legal Name | HOLSTON MEDICAL GROUP PC |
| Physicians | 239 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mary C Axelrad | Family Medicine | Holston Medical Group PC | 4848 Fort Henry Dr, Kingsport, TN 37663-3347 |
| Jeffrey Richard Many | Family Medicine | Holston Medical Group PC | 275 N Nc 16 Business Hwy, Suite 103, Denver, NC 28037-3008 |
| Connie Rutledge | Nurse Practitioner | Holston Medical Group PC | 1754 Us Hwy 23 N, Weber City, VA 24290-7071 |
| Brandi N Adams | Obstetrics/gynecology | Holston Medical Group PC | 10826 Mallard Creek Rd, Suite 200, Charlotte, NC 28262-9725 |
| Kevin Wess | Family Medicine | Holston Medical Group PC | 4675 Redbud Hwy, Honaker, VA 24260-8004 |
| Shannon M Butler | Nurse Practitioner | Holston Medical Group PC | 9611 Sherrill Estates Rd, Suite B, Huntersville, NC 28078-6485 |
| Julie M Wentz | Family Medicine | Holston Medical Group PC | 9816 Sam Furr Rd, Suite 101, Huntersville, NC 28078-5042 |
| Nancy E Deem | Nurse Practitioner | Holston Medical Group PC | 123 Professional Park Dr, Suite 200, Mooresville, NC 28117-5519 |
| Jennifer Shafer | Family Medicine | Holston Medical Group PC | 2033 Meadowview Ln, Suite 200, Kingsport, TN 37660-7432 |
| Viorel Manole | Internal Medicine | Holston Medical Group PC | 406 E Main Blvd, Church Hill, TN 37642-3405 |
| Street Address |
3500 MOUNT HOLLY HUNTERSVILLE RD SUITE B |
| City | CHARLOTTE |
| State | NC |
| Zip | 28216-8644 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kellye W Hall | Emergency Medicine | Holston Medical Group PC | 3500 Mount Holly Huntersville Rd, Suite B, Charlotte, NC 28216-8644 |
| Kristie N Singer | Nurse Practitioner | Holston Medical Group PC | 3500 Mount Holly Huntersville Rd, Suite B, Charlotte, NC 28216-8644 |
| Erika Fink | Nurse Practitioner | Holston Medical Group PC | 3500 Mount Holly Huntersville Rd, Suite B, Charlotte, NC 28216-8644 |
| Dane R Floberg | Family Medicine | Holston Medical Group PC | 3500 Mount Holly Huntersville Rd, Suite B, Charlotte, NC 28216-8644 |
| Katherine M Malta | Family Medicine | Holston Medical Group PC | 3500 Mount Holly Huntersville Rd, Suite B, Charlotte, NC 28216-8644 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashley C Mills | Clinical Social Worker | 10130 Perimeter Pkwy, Suite 226, Charlotte, NC 28216-0197 | |
| Rachael A Wruble | Optometry | 6801 Northlake Mall Dr, Suite 253, Charlotte, NC 28216-0757 | |
| Leslie Macklin | Chiropractic | 9325 Ctr Lake Dr, Suite 150, Charlotte, NC 28216-0785 | |
| Ida M Richmond | Clinical Psychologist | 5217 Elderbank Dr, Charlotte, NC 28216-1917 | |
| Leon D Knight | Physical Therapy | 10030 Callabridge Ct, Suite D, Charlotte, NC 28216-2421 | |
| Theresa Alice Bullock | Clinical Social Worker | Onsite Care Pllc | 10130 Perimeter Pkwy, Suite 200, Charlotte, NC 28216-2465 |
| Shantai Mcdermott | Nurse Practitioner | Onsite Care Pllc | 10130 Perimeter Pkwy, Suite 200, Charlotte, NC 28216-2465 |
| Veronica Nieves | Clinical Social Worker | Onsite Care Pllc | 10130 Perimeter Pkwy, Suite 200, Charlotte, NC 28216-2465 |
| Eva Krug | Clinical Social Worker | Onsite Care Pllc | 10130 Perimeter Pkwy, Suite 200, Charlotte, NC 28216-2465 |
| Kenya Lakisha Cruz | Nurse Practitioner | Onsite Care Pllc | 10130 Perimeter Pkwy, Suite 200, Charlotte, NC 28216-2465 |
| Find all physicians in zip 28216 | |||
| City | CHARLOTTE |
| Zip Code | 28216 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | CHARLOTTE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Kenyon L Draper.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.