NPIMap

Organization Active NPI

Carolina Kidney Associates

  • Nephrology Physician
  • Asheboro, NC
National Provider Identifier
1053367086
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
CAROLINA KIDNEY ASSOCIATES
Practice address
212 Foust Street
Carolina Kidney Associates PA
Asheboro, NC 27203-5404
Phone
(336) 626-0443
Fax
(336) 379-8714
NPI assigned
May 25, 2006
Last updated
Aug 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Authorized official

Name
Mrs. Beverly L McCaskill
Title
Personnel Manager
Phone
(336) 379-9708

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

212 Foust Street
Carolina Kidney Associates PA
Asheboro, NC 27203-5404

Mailing address

309 New Street
Greensboro, NC 27405-3654
Phone (336) 379-9708

Other identifiers 3

IdentifierTypeStateIssuer
01598OtherNCCKA'S BCBS GP PROV #
CD6638OtherNCCKA'S RRM GP PROV #
8901598MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040119000489 NC Part B Supplier - Clinic/Group Practice 8628979952 Receives reassigned benefits from 23 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greensboro, NC

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

309 New St
Greensboro, NC 27405
Phone (336) 379-9708

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10065404

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1053367086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 NEW STREET",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274053654",
            "telephone_number": "336-379-9708",
            "fax_number": "336-379-8714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 FOUST STREET",
            "address_2": "CAROLINA KIDNEY ASSOCIATES PA",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272035404",
            "telephone_number": "336-626-0443",
            "fax_number": "336-379-8714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA KIDNEY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "MCCASKILL",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PERSONNEL MANAGER",
        "authorized_official_telephone_number": "336-379-9708",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CKA'S BCBS GP PROV #",
            "identifier": "01598",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CKA'S RRM GP PROV #",
            "identifier": "CD6638",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901598",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.