Individual provider Active NPI

Molly R Kafka, PA-C

  • Medical Physician Assistant
  • Charlotte, NC
National Provider Identifier
1104372689
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-14543 Issued in NC
Practice address
309 S Sharon Amity Rd Ste 102
Charlotte, NC 28211-2886
Phone
(704) 926-7546
NPI assigned
Aug 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 020014-1 NY
Medical Physician Assistant 363AM0700X 0010-14543 NC Primary

Addresses

Primary practice location

309 S Sharon Amity Rd Ste 102
Charlotte, NC 28211-2886

Mailing address

309 S Sharon Amity Rd Ste 102
Charlotte, NC 28211-2886
Phone (704) 926-7546

Other practice location 1

525 E 68th St
Box 130
New York, NY 10065-4870
Phone (212) 746-4209

Medicare participation

Medicare enrollment files
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-14543NCMDMedical Physician Assistant
020014-1NYMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1104372689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 S SHARON AMITY RD STE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112886",
            "telephone_number": "704-926-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 S SHARON AMITY RD STE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112886",
            "telephone_number": "704-926-7546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 E 68th St",
            "address_2": "Box 130",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100654870",
            "country_code": "US",
            "telephone_number": "212-746-4209",
            "fax_number": "212-746-8861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAFKA",
        "first_name": "MOLLY",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-25",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "020014-1",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-14543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.