Individual provider Active NPI

Anita Emefa Kpodo, MD

  • Pediatrics Physician
  • Kings Mountain, NC
National Provider Identifier
1144432667
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2012-01413 Issued in NC
Practice address
2202 Carolina PL
Ste 200
Kings Mountain, NC 28086-8807
Phone
(980) 487-2950
NPI assigned
May 4, 2007
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2012-01413 NC Primary

Addresses

Primary practice location

2202 Carolina PL
Ste 200
Kings Mountain, NC 28086-8807

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

709 N Dekalb St
Shelby, NC 28150-3911
Phone (980) 487-2100

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address akpodo423413@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
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
I20150122000230 NC Practitioner - Pediatric Medicine 9436398195 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012-01413NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gaston Family Health Services, Inc. CurrentSince Nov 11, 2014 Accepting new patients
Gaston Family Health Services, Inc CurrentSince Nov 11, 2014 Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients

Locations

991 W Hudson Blvd
Gastonia, NC 28052
Phone (704) 853-5000

200 E 2nd Ave
Gastonia, NC 28052
Phone (704) 874-1904

925 Thomas St
Ste A
Statesville, NC 28677
Phone (704) 872-0174

518 Brookdale Dr
Statesville, NC 28677
Phone (704) 838-1108

Interoperability endpoints

  • Direct secure messaging: akpodo423413@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1144432667",
    "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": "2202 CAROLINA PL",
            "address_2": "STE 200",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280868807",
            "telephone_number": "980-487-2950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "709 N Dekalb St",
            "address_purpose": "LOCATION",
            "city": "Shelby",
            "state": "NC",
            "postal_code": "281503911",
            "country_code": "US",
            "telephone_number": "980-487-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KPODO",
        "first_name": "ANITA",
        "middle_name": "EMEFA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2024-07-15",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2012-01413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akpodo423413@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "2202 Carolina Pl",
            "address_2": "Ste 200",
            "city": "Kings Mountain",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280868807",
            "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 Kings Mountain, NC

Sources for this page

Verify at the official NPI Registry.