Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kenneth Roland Blanton, PA

Individual provider Physician Assistant · NPI 1639194715

Kenneth Roland Blanton, PA is a Physician Assistant in Wilmington, North Carolina. Qualified in 1993, 33 years ago. Practices with Novant Health Medical Group Coastal Region LLC, a 576-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
33
Licensed in
NC
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2131 S 17th St
Wilmington, NC 28401-7407
Phone: (910) 667-2606
Fax: (910) 815-5698
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 2153 Valleygate Dr Ste 101, Fayetteville, NC 28304-3667 — (910) 672-0350
  • 1912 Tradd Ct, Wilmington, NC 28401-6637 — (910) 251-3766

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 100409 (NC)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1639194715
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 12, 2006
Last updated in NPPESJune 18, 2025
Certification dateJune 18, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1993 (33 years in practice)
Group practice Novant Health Medical Group Coastal Region Llc — 576 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Wilmington