Individual provider Active NPI

Kulsum Bano, MD

  • Hematology & Oncology Physician
  • Charlotte, NC
National Provider Identifier
1114378775
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
2019-01891 Issued in NC
Practice address
10660 Park Rd
Ste 1100
Charlotte, NC 28210-8413
Phone
(980) 442-5400
NPI assigned
Jun 24, 2016
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2019-01891 NC
Hematology & Oncology Physician 207RH0003X 2019-01891 NC Primary

Addresses

Primary practice location

10660 Park Rd
Ste 1100
Charlotte, NC 28210-8413

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

100 Medical Park Dr
Ste 110
Concord, NC 28025-2948
Phone (704) 403-1370

Other practice location 2

4525 Cameron Valley Pkwy
Ste 3500
Charlotte, NC 28211-4369
Phone (704) 302-8300

Other practice location 3

1021 Morehead Medical Dr
Ste A
Charlotte, NC 28204-2990
Phone (980) 442-2000

Other practice location 4

945 N 5th St
Albemarle, NC 28001-3417
Phone (980) 323-7790

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kbano1236679@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191014003585 NC Practitioner - Hematology/OncologyPractitioner - Internal MedicinePractitioner - Hospitalist 8527355320 Reassigns benefits to 1 organization
I20231115003528 SC Practitioner - Hematology/OncologyPractitioner - Internal Medicine 8527355320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Charlotte-Mecklenburg Hospital AuthorityGroup PAC ID 2961310685, shared by 6 NPIs, 594 clinicians

Practice addresses (Care Compare)

10660 Park Rd
Suite 1100
Charlotte, NC 28210-8407
Phone (980) 442-5400

1656 Riverchase Blvd
Suite 1400
Rock Hill, SC 29732-0281
Phone (803) 329-9088

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine CurrentSince Sep 19, 2023 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine CurrentSince Sep 19, 2023 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Sep 19, 2023 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

945 N 5th St
Albemarle, NC 28001
Phone (980) 323-7790

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1021 Morehead Medical Dr
Ste A
Charlotte, NC 28204
Phone (704) 355-2884

10660 Park Rd
Ste 1100
Charlotte, NC 28210
Phone (980) 442-0865

4525 Cameron Valley Pkwy
Ste 3500
Charlotte, NC 28211
Phone (704) 302-8300

100 Medical Park Dr
Ste 110
Concord, NC 28025
Phone (704) 403-1370

201 E Grover St
Shelby, NC 28150
Phone (704) 487-3000

7666 Charlotte Hwy
#200A
Indian Land, SC 29707
Phone (704) 302-9600

1656 Riverchase Blvd
Ste 1400
Rock Hill, SC 29732
Phone (803) 329-9088

Interoperability endpoints

  • Direct secure messaging: kbano1236679@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1114378775",
    "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": "10660 PARK RD",
            "address_2": "STE 1100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108413",
            "telephone_number": "980-442-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Medical Park Dr",
            "address_2": "Ste 110",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252948",
            "country_code": "US",
            "telephone_number": "704-403-1370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4525 Cameron Valley Pkwy",
            "address_2": "Ste 3500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282114369",
            "country_code": "US",
            "telephone_number": "704-302-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1021 Morehead Medical Dr",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042990",
            "country_code": "US",
            "telephone_number": "980-442-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "945 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Albemarle",
            "state": "NC",
            "postal_code": "280013417",
            "country_code": "US",
            "telephone_number": "980-323-7790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANO",
        "first_name": "KULSUM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2024-07-15",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2019-01891",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "2019-01891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbano1236679@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "10660 Park Rd",
            "address_2": "Ste 1100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282108413",
            "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": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.