Provider Demographics
NPI:1457315418
Name:KIGHT'S MEDICAL CORP
Entity Type:Organization
Organization Name:KIGHT'S MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:KIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:919-878-6666
Mailing Address - Street 1:201 KITTY HAWK DR
Mailing Address - Street 2:SUITE 95
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-7659
Mailing Address - Country:US
Mailing Address - Phone:919-878-6666
Mailing Address - Fax:919-878-4411
Practice Address - Street 1:201 KITTY HAWK DR
Practice Address - Street 2:SUITE 95
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-7659
Practice Address - Country:US
Practice Address - Phone:919-878-6666
Practice Address - Fax:919-878-4411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00562332B00000X
NC05612332BX2000X
NC01023332BX2000X
VA0206009179332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0303780332OtherDEPT OF LABOR
VA009111361Medicaid
NC0464TOtherBCBS OF NC
NC15527OtherWELLPATH
NC7701287Medicaid
SCDE2019Medicaid
NC15527OtherWELLPATH
NC=========004OtherTRICARE
NC15527OtherWELLPATH