KEVIN S SCULLY MD
NPI 1114983772
Orthopaedic Surgery - Sports Medicine in Wilmington, NC

Q: What is Kevin Scully's NPI number?

The NPI number for Kevin Scully is 1114983772. It was assigned to this individual provider in the NPPES registry on April 24, 2006.

Q: What is Kevin Scully's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Scully was last updated on July 26, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 24, 2006

2716 ASHTON DR, WILMINGTON, NC 28412(910) 332-3800(910) 251-0421 Get Directions Write a Review

NPPES record last updated: July 26, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kevin S Scully Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN S SCULLY MD (NPI 1114983772) is an individual sports medicine provider in Wilmington, North Carolina, licensed in North Carolina (28340) and active in the NPI registry since April 2006.

NPPES Registry Identity

NPI1114983772

Entity TypeIndividualMale

Primary Taxonomy207XX0005X

Provider Legal NameKEVIN S SCULLYCredential: MD

Location Address2716 ASHTON DRWilmington, NC 28412-2489

Mailing Address2716 Ashton DrWilmington, NC 28412-2489 · (910) 332-3800 · Fax (910) 251-0421

Phone(910) 332-3800

Fax(910) 251-0421

Sole ProprietorNo

Enumeration DateApril 24, 2006

Last NPPES UpdateJuly 26, 2012

✔ NPI 1114983772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207XX0005X

License✔ Licensed in NC · 28340

Definition

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License 28340 (NC)

2716 ASHTON DR, Wilmington, NC 28412

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Other Identifiers 4

OtherP01048395Rr Medicare

Medicaid8975089NC

Medicare UPINA51939

Medicare PINNC5812A

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROBIN ELIZABETH JENDRAZAK OPA-C

Physician Assistant (Surgical)