Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Miss. Carolyn Green Kellaway, PA-C

Individual provider Medical Physician Assistant · NPI 1457647604

Miss. Carolyn Green Kellaway, PA-C is a Physician Assistant in Pinehurst, North Carolina. Qualified in 2011, 15 years ago. Practices with Pinehurst Surgical Clinic PA, a 92-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
15
Licensed in
NC
In the registry since
2011
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

5 Firstvillage Dr
Pinehurst, NC 28374
Phone: (910) 295-6831
Fax: (910) 295-0244
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 001003031 (NC)

Record details

NPI number1457647604
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 27, 2011
Last updated in NPPESOctober 4, 2019

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Pinehurst Surgical Clinic Pa — 92 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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