Licensee Information

Kimberly Mallick Fillman - PA-C

License #:

101827

License Status:

Active

Public Action:

Issue Date:

01/25/1995

Renewal Date:

04/22/2027

Active Supervisor

Name	Type	Status	Approved	Inactive
Jordanhazy, Ryan Alan, MD	MD	Active	02/06/2019

North Carolina Hospital Admitting Privileges

Location
Novant Health Brunswick Medical Center

Out of State Active/Inactive Licenses

State
South Carolina

Out of Country Active/Inactive Licenses

Country
None Reported

Address

Brunswick Physician Partners
240 Hospital Dr. NE
Bolivia, NC 28422
910-721-1700

Information

Days patients are seen at this practice: everyday

Practice philosophy:

Non-English languages in which office is able to provide clinical services (e.g. Hindi, Spanish): spanish

Non-English languages in which practitioner is able to provide clinical services (e.g. Hindi, Spanish):

Participates in Medicare:

Accepting new Medicare patients:

Participates in Medicaid:

Accepting new Medicaid patients:

Uses electronic medical records:

PA School

School	Graduation
George Washington	1994

Area of Practice

Area Of Practice	Primary
Emergency Medicine	Yes

Current Membership in Medical Professional Organizations

Membership
None Reported

Honors & Awards

Honor/Award	Given By	Date
None Reported

Public Service

Name of Clinic	Service Description	Date
None Reported

Current Academic Appointments

Title	Institution	City, State, Country
None Reported

Publications

Title
None Reported

Section 1: Adverse Actions

North Carolina Medical Board Public Actions

Date	Description	Link
None Reported

Other Regulatory Board or Agency Public Actions

Date	Name of Board/Agency	Action Taken	Link
None Reported

Health Care Institution Suspensions and Revocations

Date	Health Care Institution	Action Taken
None Reported

Section 2: Administrative Actions

Actions listed in this section are considered non-disciplinary by the Board. In situations where administrative actions are taken, the licensee may not have met certain statutory requirements or may have failed to follow correct administrative procedures.

North Carolina Medical Board Reentry Agreement

Date	Description	Link
None Reported

North Carolina Special Purpose Licensing Agreement

Date	Description	Link
None Reported

Malpractice Information

Incident Date	Payment Date	Area of Practice	City, State, Country	Response
None Reported

Misdemeanor/DUI/DWI Conviction Information

Conviction Date	Conviction	Jurisdiction	Sentence
None Reported

Felony Conviction Information

Conviction Date	Conviction	Jurisdiction	Sentence
None Reported

Information loaded from this database is current as of 7/29/2026 9:16:32 AM

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