Provider Demographics
NPI:1417943986
Name:MASSEY, KURT ASHLEY (DPM)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:ASHLEY
Last Name:MASSEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 PROFESSIONAL PARK DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6540
Mailing Address - Country:US
Mailing Address - Phone:704-662-8336
Mailing Address - Fax:704-662-8525
Practice Address - Street 1:137 PROFESSIONAL PARK DR
Practice Address - Street 2:SUITE C
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-6540
Practice Address - Country:US
Practice Address - Phone:704-662-8336
Practice Address - Fax:704-662-8525
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC464213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890809UMedicaid
NC890809UMedicaid
NCU96136Medicare UPIN
NC2433672BMedicare PIN