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

Kerry Keldon Mackey Sr.

Individual provider Physician Assistant · NPI 1417599580

Kerry Keldon Mackey Sr. is a Physician Assistant in Raleigh, North Carolina. Qualified in 2019, 7 years ago. Practices with Advance Community Health Inc, a 32-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in North Carolina.

Years since qualifying
7
Licensed in
NC
In the registry since
2019
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Practice location Address checks out

4700 Falls Of Neuse Rd Ste 355
Raleigh, NC 27609-6275
Phone: (919) 876-3130
Fax: (888) 438-1446
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1001 Rock Quarry Rd, Raleigh, NC 27610-3825 — (919) 833-3111

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 001009499 (NC)

Record details

NPI number1417599580
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 10, 2019
Last updated in NPPESMay 20, 2026
Certification dateMay 20, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Advance Community Health Inc — 32 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

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