Kristina L. Kelly, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

200200243 Issued in NC

Practice address

105 Yadkin St
Ste 303
Albemarle, NC 28001-3449

Phone

(980) 323-5400

NPI assigned

Apr 16, 2009

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

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkelly136991@carolinashealthcaresystem.direct-ci.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.

• Carolinas Physicians Network Inc

  • Orthopaedic Surgery Physician
  • Charlotte, NC
  • NPI 1437607686
  Medicare reassignment NPD
• Carolinas Physician Network Inc

  • Pediatrics Physician
  • Albemarle, NC
  • NPI 1902200991
  NPD
• Carolinas Physicians Network Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1437038544
  NPD
• Carolinas Physicians Network, Inc

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1578939914
  NPD (past)
• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  NPD (past)
• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Lexington, NC
  • NPI 1639454499
  NPD (past)

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

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1093958308",
    "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": "105 YADKIN ST",
            "address_2": "STE 303",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013449",
            "telephone_number": "980-323-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KRISTINA",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-16",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200200243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkelly136991@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "105 Yadkin St",
            "address_2": "Ste 303",
            "city": "Albemarle",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280013449",
            "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": []
}

• Louis Charles Kandl, M.D.
• Karen Korzelius
• Evelina Kartsimaris, MD
• Gina Kay Kavanagh, P-LCSW
• Barbara Grant Kelly
• Edward A Kepp, MD
• Jamaica Kei Kersey, MSW, LCSW-A
• John D Kilde, MD
• Judy Forbis Kilgore, RN
• Kimberly Michele Draper, DDS PLLC

• Pediatrics Physician in Albemarle, NC
• Providers in Albemarle, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.