Kiley Donita Daughtry , N, A

Physician • Jacksonville, NC

Active NPI 1154048999 Individual Practitioner Female Practitioner

Practice location in NPPES

703 Jim Blake Rd
Jacksonville, NC 285407705

Call 9109670374 Location details and other listings

Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

NPI assigned on October 24, 2022; this date does not establish years in practice.
No Medicare Part B / Part D records for this NPI in the CMS files shown here. CMS covers only Medicare fee-for-service / Part D claims and omits records with fewer than 11 beneficiaries, so this does not show whether the provider accepts Medicare or prescribes.

Practice Location & Contact Primary Location

Practice Address

703 Jim Blake Rd

Jacksonville, NC 285407705

Telephone 9109670374

Fax 9104691275

Before You Book

Paying without insurance? Prepare a cost-estimate request

Ask about interpreters and office accessibility

Organization at the Same NPPES Address or Phone

Angels Care Assisted Living, Llc Facility NPI 1376363341

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

What Public CMS Data Show

These CMS figures cover limited populations and published records; they are not quality ratings or medical advice.

Physician: NPPES taxonomy is a reported classification, not proof of board certification.

NPI first issued

2022

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-10-10

Assisted Living Facility Primary Specialty

NUCC Taxonomy Code: 310400000X

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: North Carolina Medical Board.

Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events

📍

Updated Practice Location October 10, 2024

Registered at 703 JIM BLAKE RD, JACKSONVILLE, NC 285407705 (Tel: 9109670374)

📍

Updated Business Mailing Address October 10, 2024

Registered at 703 JIM BLAKE RD, JACKSONVILLE, NC 285407705 (Tel: 9109670374)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 10, 2024

Assisted Living Facility

✅

NPI Profile Active October 24, 2022

NPI status registered as active in NPPES database

📍

Practice Location (Initial Record) October 24, 2022

Registered at 131 BALSAM RD, JACKSONVILLE, NC 285468562 (Tel: 9109670374)

📍

Business Mailing Address (Initial Record) October 24, 2022

Registered at 131 BALSAM RD, JACKSONVILLE, NC 285468562 (Tel: 9109670374)

👤

Provider Name / Credentials (Initial Record) October 24, 2022

Recorded as KILEY DAUGHTRY, N/A

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 24, 2022

Non-emergency Medical Transport (VAN)

🟢

Initial NPI Registration & Enumeration October 24, 2022

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1154048999

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 24, 2022

Last Update: October 10, 2024

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

703 Jim Blake Rd

Jacksonville, NC 285407705

Phone: 9109670374

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.