Individual provider Active NPI

Kimberly Nesbitt Montgomery, FNP

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1013979228
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201590 Issued in NC
Practice address
3030 Randolph Rd
Ste 200
Charlotte, NC 28211-1368
Phone
(704) 512-5000
NPI assigned
Apr 4, 2006
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
Nurse Practitioner 363L00000X 201590 NC
Family Nurse Practitioner 363LF0000X 201590 NC Primary

Addresses

Primary practice location

3030 Randolph Rd
Ste 200
Charlotte, NC 28211-1368

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kmontgomery332228@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
I20051229000739 NC Practitioner - Nurse Practitioner 6406878768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
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)

3030 Randolph Rd
Charlotte, NC 28211-1368
Phone (704) 512-5000

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113

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
201590NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Jan 1, 2025 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 1, 2025 Accepting new patients

Locations

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

3030 Randolph Rd
Charlotte, NC 28211
Phone (704) 512-4420

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

3030 Randolph Rd
Ste 200
Charlotte, NC 28211
Phone (704) 302-8200

4105 Matthews Mint Hill Rd
Matthews, NC 28105
Phone (704) 316-3095

Interoperability endpoints

  • Direct secure messaging: kmontgomery332228@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 3

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": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1013979228",
    "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": "3030 RANDOLPH RD",
            "address_2": "STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111368",
            "telephone_number": "704-512-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "KIMBERLY",
        "middle_name": "NESBITT",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-04",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "201590",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "201590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmontgomery332228@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "3030 Randolph Rd",
            "address_2": "Ste 200",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282111368",
            "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 Charlotte, NC

Sources for this page

Verify at the official NPI Registry.