Organization Active NPI

Carolina Internal Medicine Associates PA

Doing business as Carolina Internal Medicine

  • Internal Medicine Physician
  • Asheville, NC
National Provider Identifier
1154086858
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CAROLINA INTERNAL MEDICINE ASSOCIATES PA
Doing business as
Carolina Internal Medicine
Practice address
275 McDowell St
Asheville, NC 28803-2606
Phone
(828) 258-0397
Fax
(828) 277-7815
NPI assigned
Nov 8, 2021
Last updated
Nov 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Authorized official

Name
Kenneth Raphael Kubitschek, MDNPI 1619950730
Title
Owner
Phone
(828) 258-0397

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

275 McDowell St
Asheville, NC 28803-2606

Mailing address

4 Vanderbilt Park Dr Ste 100
Asheville, NC 28803-2476
Phone (828) 258-0397

Other names 1

  • Carolina Internal Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040629001069 NC Part B Supplier - Clinic/Group Practice 8426034422 Receives reassigned benefits from 28 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Asheville, NC; Clyde, NC

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2247812Carolina Internal Medicine Associates275 McDowell Street, Asheville, NC 28803Certificate of waiverJan 9, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637193600000",
    "number": "1154086858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 VANDERBILT PARK DR STE 100",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288032476",
            "telephone_number": "828-258-0397",
            "fax_number": "828-277-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MCDOWELL ST",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288032606",
            "telephone_number": "828-258-0397",
            "fax_number": "828-277-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA INTERNAL MEDICINE ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A",
        "authorized_official_last_name": "KUBITSCHEK",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "RAPHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-258-0397",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carolina Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Asheville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.