Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KIM KERRY NEELY PAC
NPI 1912084013
Physician Assistant in Statesville, NC

Q: What is Kim Neely's NPI number?

The NPI number for Kim Neely is 1912084013. It was assigned to this individual provider in the NPPES registry on November 1, 2006.

Q: What is Kim Neely's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Kim Neely was last updated on August 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 days 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 November 01, 2006PECOS Enrolled

2001 VAN HAVEN DR, STATESVILLE, NC 28625(704) 942-7922(704) 828-8248 Get Directions Write a Review

NPPES record last updated: August 6, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Kim Kerry Neely Pac NPPES

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

KIM KERRY NEELY PAC (NPI 1912084013) is an individual physician assistant in Statesville, North Carolina, licensed in North Carolina (102318) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912084013

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKIM KERRY NEELYCredential: PAC

Location Address2001 VAN HAVEN DRStatesville, NC 28625-4342

Mailing Address12824 District South Dr Apt 6414Charlotte, NC 28277-5221 · (704) 996-4973 · Fax (704) 828-8248

Phone(704) 942-7922

Fax(704) 828-8248

Sole ProprietorYes

Enumeration DateNovember 1, 2006

Last NPPES UpdateAugust 6, 2026

NPPES CertifiedAugust 6, 2026

✔ NPI 1912084013 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in NC · 102318

Definition

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.

2001 VAN HAVEN DR, Statesville, NC 28625

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Other Identifiers 1

Medicaid561976679NC

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kim Kerry Neely Pac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28625 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$57.52 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$27.03 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

2 suppliers13 claims13 services$17.14 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 12

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

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