Individual provider Active NPI

Kimberly Smith Gallagher, FNP

  • Family Nurse Practitioner
  • Concord, NC
National Provider Identifier
1013324334
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5007052 Issued in NC
Practice address
349 Penny LN
Concord, NC 28025-1221
Phone
(704) 786-7158
NPI assigned
Jul 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5007052 NC Primary
Nurse Practitioner 363L00000X 5007052 NC

Addresses

Primary practice location

349 Penny LN
Concord, NC 28025-1221

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1054 Burrage Rd NE
Concord, NC 28025-2910
Phone (704) 403-7800

Other practice location 2

2101 Shiloh Church Rd
Ste 202
Davidson, NC 28036-7601
Phone (704) 403-7800

Other practice location 3

4315 Physicians Blvd
Ste 201
Harrisburg, NC 28075-7430
Phone (704) 786-7158

Other practice location 4

101 E W T Harris Blvd
Ste 2320
Charlotte, NC 28262-3485
Phone (704) 547-0858

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kgallagher385488@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141125001419 NC Practitioner - Nurse Practitioner 2365764594 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, shared by 56 NPIs, 2,324 clinicians

Practice addresses (Care Compare)

319 Penny LN
Concord, NC 28025-1221
Phone (704) 786-7158

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5007052NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Aug 6, 2017 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Aug 6, 2017 Accepting new patients
Carolinas Physicians Network Inc Family CurrentSince May 18, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 11, 2018 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 11, 2018 Accepting new patients
Northeast Anesthesia and Pain Specialists PA CurrentSince Jun 29, 2015 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Past Accepting new patients
Carolina Pain and Weight Loss, PA Nurse Practitioner Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

101 E Wt Harris Blvd
Ste 2320
Charlotte, NC 28262
Phone (704) 547-0858

319 Penny Ln
Concord, NC 28025
Phone (704) 262-1911

1085 NE Gateway Ct NE
#200A
Concord, NC 28025
Phone (704) 403-8650

1054 Burrage Rd NE
Concord, NC 28025
Phone (704) 403-7800

349 Penny Ln
Concord, NC 28025
Phone (704) 786-7158

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

2101 Shiloh Church Rd
Ste 202
Davidson, NC 28036
Phone (704) 403-7800

4315 Physicians Blvd
Ste 201
Harrisburg, NC 28075
Phone (704) 455-5508

Interoperability endpoints

  • Direct secure messaging: kgallagher385488@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1013324334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 PENNY LN",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251221",
            "telephone_number": "704-786-7158"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1054 Burrage Rd NE",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252910",
            "country_code": "US",
            "telephone_number": "704-403-7800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2101 Shiloh Church Rd",
            "address_2": "Ste 202",
            "address_purpose": "LOCATION",
            "city": "Davidson",
            "state": "NC",
            "postal_code": "280367601",
            "country_code": "US",
            "telephone_number": "704-403-7800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4315 Physicians Blvd",
            "address_2": "Ste 201",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "NC",
            "postal_code": "280757430",
            "country_code": "US",
            "telephone_number": "704-786-7158",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 E W T Harris Blvd",
            "address_2": "Ste 2320",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623485",
            "country_code": "US",
            "telephone_number": "704-547-0858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "KIMBERLY",
        "middle_name": "SMITH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-18",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5007052",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5007052",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgallagher385488@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "349 Penny Ln",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280251221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.