Healthcare Provider Details

I. General information

NPI: 1083235873
Provider Name (Legal Business Name): DR. KELLY ANN ORGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KELLY ANN GEWAIN

II. Dates (important events)

Enumeration Date: 05/03/2020
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1512 E FRANKLIN ST STE 100
CHAPEL HILL NC
27514-2816
US

IV. Provider business mailing address

PEDIATRIC EDUCATION OFFICE CB 7593
CHAPEL HILL NC
27599-7593
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-3150
  • Fax: 984-974-5608
Mailing address:
  • Phone: 919-966-3172
  • Fax: 919-966-8419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2023-02125
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number262754
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number2023-02125
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: