NPIMap

Individual provider Active NPI

Kylee Nutter, PA

  • Medical Physician Assistant
  • Monroe, NC
National Provider Identifier
1013789734
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-13698 Issued in NC
Practice address
404 S Sutherland Ave
Monroe, NC 28112-5060
Phone
(704) 291-9267
NPI assigned
Oct 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-13698 NC Primary

Addresses

Primary practice location

404 S Sutherland Ave
Monroe, NC 28112-5060

Mailing address

1116 W 1St St
Charlotte, NC 28202-1076
Phone (405) 657-0955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240422003398 NC Practitioner - Physician Assistant 3870932932 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Oklahoma College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

1585 Forney Creek Pkwy
Suite 2100
Denver, NC 28037-9520
Phone (980) 212-6230

4429 W Hwy 27
Vale, NC 28168-9656
Phone (704) 748-2245

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
First Care Medical Clinic CurrentSince Jan 20, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 7, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 7, 2024 Accepting new patients
First Care Medical Clinic, PA CurrentSince Jan 20, 2024 Accepting new patients

Locations

1426 E Main St
Albemarle, NC 28001
Phone (704) 982-0950

2938 The Plaza
Charlotte, NC 28205
Phone (704) 375-0404

9040 Nations Ford Rd
Charlotte, NC 28273
Phone (704) 225-8548

404 S Sutherland Ave
Monroe, NC 28112

4429 W Highway 27
Vale, NC 28168
Phone (704) 748-2245

Interoperability endpoints

  • Direct secure messaging: knutter2934357@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

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

Hospital & facility affiliations 7

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": "1698192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1013789734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 W 1ST ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282021076",
            "telephone_number": "405-657-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 S SUTHERLAND AVE",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281125060",
            "telephone_number": "704-291-9267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTTER",
        "first_name": "KYLEE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-25",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-13698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

Verify at the official NPI Registry.