Phyllis T. Kupsick, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

201184 Issued in NC

Practice address

313 Yadkin St
Albemarle, NC 28001-3441

Phone

(704) 984-4388

Fax

(704) 984-4132

NPI assigned

Jan 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: phyllis.kupsick.1@26885.direct.athenahealth.com

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.

• The Charlotte-Mecklenburg Hospital Authority

  • General Acute Care Hospital
  • Albemarle, NC
  • NPI 1144688219
  NPD
• The Charlotte-Mecklenburg Hospital Authority

  • Rehabilitation Hospital Unit
  • Charlotte, NC
  • NPI 1962987131
  NPD
• The Charlotte-Mecklenburg Hospital Authority

  • Medical Oncology Physician
  • Indian Land, SC
  • NPI 1669738829
  NPD
• Central Carolina Medical Associates, PA

  • Internal Medicine Physician
  • Albemarle, NC
  • NPI 1497735179
  NPD (past)
• Revelstone Family Practice

  • Family Medicine Physician
  • Albemarle, NC
  • NPI 1790143436
  NPD (past)

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1033199682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 YADKIN ST",
            "address_2": "SUITE B",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013447",
            "telephone_number": "704-983-7320",
            "fax_number": "704-983-6153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 YADKIN ST",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013441",
            "telephone_number": "704-984-4388",
            "fax_number": "704-984-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPSICK",
        "first_name": "PHYLLIS",
        "middle_name": "T.",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "201184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8984978",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0105E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanna Doreen Kosko, M.D.
• Victoria Lynn Kottyan, RD, PA-C
• KP Homecare Services, Inc
• James Ronald Krug, MD
• Gloria Kubuanu, PA-C
• Kristen Lanae Laaman, MD
• Jodie Hallman Lafollette, LPC
• Stacey Lambert
• Lisa Shaw Lambeth, OTAL
• Larry P Jenkins MD PA

• Family Nurse Practitioner in Albemarle, NC
• Providers in Albemarle, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.