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

Individual provider Physician Assistant · NPI 1669473153

Kerry Clancy, PA is a Physician Assistant in Fayetteville, North Carolina. Qualified in 1999, 27 years ago. Practices with Matrix Occupational Health PC, a 42-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
27
Licensed in
NC
In the registry since
2005
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

217 Glensford Dr
Fayetteville, NC 28314
Phone: (910) 483-4647
Fax: (910) 483-6431
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 620 Fairbluff Dr, Hope Mills, NC 28348-5670 — (910) 423-0804

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 000102790 (NC)

Record details

NPI number1669473153
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 9, 2005
Last updated in NPPESSeptember 10, 2019

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Matrix Occupational Health Pc — 42 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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