Individual provider Active NPI

Kelsey Kocjancic

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
National Provider Identifier
1043554249
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
90996 Issued in NC
Practice address
222 E Bland St
Apt 281
Charlotte, NC 28203-6142
Phone
(814) 335-2542
NPI assigned
Nov 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 241335 NC
Certified Registered Nurse Anesthetist 367500000X 90996 NC Primary

Addresses

Primary practice location

222 E Bland St
Apt 281
Charlotte, NC 28203-6142

Mailing address

222 E Bland St
Apt 281
Charlotte, NC 28203-6142
Phone (814) 335-2542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130320000410 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395980494 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHS Anesthesia Services Group IncGroup PAC ID 5799007324, 742 clinicians

Practice addresses (Care Compare)

8800 N Tryon St
Charlotte, NC 28262-3300
Phone (704) 863-6000

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Atrium Health Union Hospital, Monroe, NC, CCN 340130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
90996NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Anesthesia Services Group Inc CurrentSince Nov 16, 2017 Accepting new patients
East Carolina Anesthesia Associates, PLLC Registered Nurse CurrentSince Sep 1, 2025 Accepting new patients
Mercy Hospital, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2711 Randolph Rd
Ste 207
Charlotte, NC 28207
Phone (704) 862-4700

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

2825 Randolph Rd
Charlotte, NC 28211
Phone (704) 377-1647

2001 Vail Ave
Charlotte, NC 28207
Phone (704) 304-5000

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

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 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": "1352678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1043554249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E BLAND ST",
            "address_2": "APT 281",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282036142",
            "telephone_number": "814-335-2542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E BLAND ST",
            "address_2": "APT 281",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282036142",
            "telephone_number": "814-335-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCJANCIC",
        "first_name": "KELSEY",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-12",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "241335",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "90996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.