Shannon Marie Kimmel

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5018442 Issued in NC

Practice address

9200 Glenwater Dr
Charlotte, NC 28262-8557

Phone

(901) 603-8704

NPI assigned

Jul 12, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Shannon Marie Spencer Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kinetic Medical GroupGroup PAC ID 5294141909, 10 clinicians

Physicians Eldercare PAGroup PAC ID 0648184705, 236 clinicians

Curana Health of North Carolina PLLCGroup PAC ID 1850774332, 274 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Curana Health of North Carolina PLLC

  • Internal Medicine Physician
  • Durham, NC
  • NPI 1770217176
  Medicare reassignment Care Compare group NPD
• Physicians Eldercare PA

  • General Practice Physician
  • Durham, NC
  • NPI 1023083268
  Medicare reassignment Care Compare group NPD
• Kinetic Medical Group

  • Family Nurse Practitioner
  • Potomac, MD
  • NPI 1285228585

  NC

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1104505890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6304 DURANGO WAY",
            "city": "DENVER",
            "state": "NC",
            "postal_code": "280371429",
            "telephone_number": "989-600-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 GLENWATER DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282628557",
            "telephone_number": "901-603-8704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMMEL",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-12",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5018442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "SPENCER",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dawn Michelle Kimble
• Kira Kimble, CD
• Jamie Leigh Rembert Kimbrell, PHARMD
• Kasey Hannah Kimbrell, PTA
• Aude Kimbrew
• Lisa Yong Kimmerle, CRNA
• Kin Psychology, PLLC
• Makeya Kinard
• Shena Chantese Kinard
• Aaron Kincaid, LPCA

• Family Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; 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.
• 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.