Individual provider Active NPI

Kaylee Anne Vandommelen, MD MPH

  • Obstetrics & Gynecology Physician
  • Matthews, NC
National Provider Identifier
1063972180
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
250401 Issued in NC
Practice address
1450 Matthews Township Pkwy Ste 200
Matthews, NC 28105-2388
Phone
(704) 246-1846
Fax
(704) 246-1462
NPI assigned
Mar 24, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 250401 NC Primary

Addresses

Primary practice location

1450 Matthews Township Pkwy Ste 200
Matthews, NC 28105-2388

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-1544

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230801003416 NC Practitioner - Obstetrics/Gynecology 3678800174 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Miami, LM Miller School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

1450 Matthews Township Pkwy
Suite 200
Matthews, NC 28105-2388
Phone (704) 246-1846

1955 S US 29 Hwy
China Grove, NC 28023-5684
Phone (704) 855-7611

Hospital & facility affiliations

  • Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
250401NCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Obstetrics & Gynecology CurrentSince Aug 1, 2023 Accepting new patients
Novant Health Medical Group, LLC Obstetrics & Gynecology CurrentSince Aug 1, 2023 Accepting new patients
Novant Health Medical Group, LLC Obstetrics & Gynecology CurrentSince Aug 1, 2023 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations (25 of 26)

3129 Springbank Ln
Ste 100
Charlotte, NC 28226
Phone (704) 316-2021

8820 Rachel Freeman Way
Charlotte, NC 28278
Phone (704) 316-3608

1918 Randolph Rd
Ste 670
Charlotte, NC 28207
Phone (704) 334-9535

8201 Healthcare Loop
Ste 302
Charlotte, NC 28215
Phone (704) 316-2319

1718 E 4th St
Ste 907
Charlotte, NC 28204
Phone (704) 372-4000

10905 Providence Rd W
Ste 260
Charlotte, NC 28277
Phone (704) 542-0744

6324 Fairview Rd
Ste 430
Charlotte, NC 28210
Phone (704) 316-3148

5933 Blakeney Park Dr
Ste 100
Charlotte, NC 28277
Phone (704) 316-2021

325 Hawthorne Ln
Ste 200
Charlotte, NC 28204
Phone (704) 334-0802

12611 N Community House Rd
Ste 200
Charlotte, NC 28277
Phone (704) 731-1014

14215 Ballantyne Corporate Pl
Ste 110
Charlotte, NC 28277
Phone (704) 384-1620

2711 Randolph Rd
Ste 512
Charlotte, NC 28207
Phone (704) 333-4101

15825 Ballantyne Medical Pl
Ste 200
Charlotte, NC 28277
Phone (704) 384-1925

1718 E 4th St
Ste 201
Charlotte, NC 28204
Phone (704) 384-0560

1955 S US 29 Hwy
China Grove, NC 28023
Phone (704) 855-7611

9955 Poplar Tent Rd
Concord, NC 28027
Phone (704) 316-1161

17810 Statesville Rd
Ste 321
Cornelius, NC 28031
Phone (704) 895-5394

6555 Kee Ln
Ste 200
Harrisburg, NC 28075
Phone (704) 316-2319

14330 Oakhill Park Ln
Ste 200
Huntersville, NC 28078
Phone (704) 316-1265

9930 Kincey Ave
Ste 360
Huntersville, NC 28078

14330 Oakhill Park Ln
Ste 100
Huntersville, NC 28078

1450 Matthews Township Pkwy
Ste 200
Matthews, NC 28105
Phone (704) 246-1846

1450 Matthews Township Pkwy
Ste 300
Matthews, NC 28105
Phone (704) 316-6860

911 W Henderson St
Ste 300
Salisbury, NC 28144
Phone (704) 636-9270

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

Interoperability endpoints

  • Direct secure messaging: kvandommelen1143340@direct.novanthealth.org

Organizations & group practices 6

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 5

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": "1553385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1063972180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 MATTHEWS TOWNSHIP PKWY STE 200",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281052388",
            "telephone_number": "704-246-1846",
            "fax_number": "704-246-1462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-1544",
            "fax_number": "704-446-1551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDOMMELEN",
        "first_name": "KAYLEE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-24",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "250401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.