Individual provider Active NPI

Kellye Hall, MD

  • Emergency Medicine Physician
  • Charlotte, NC
National Provider Identifier
1154463370
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2007-00968 Issued in NC
Practice address
101 E WT Harris Blvd
Ste 5002
Charlotte, NC 28262-3485
Phone
(704) 801-7310
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2007-00968 NC Primary

Addresses

Primary practice location

101 E WT Harris Blvd
Ste 5002
Charlotte, NC 28262-3485

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277-3372
Phone (704) 667-2650

Other practice location 2

101 E W T Harris Blvd
Ste 5401
Charlotte, NC 28262-3485
Phone (704) 863-9700

Other practice location 3

150 Professional Park Dr
Ste 400
Mooresville, NC 28117-5603
Phone (704) 801-7360

Other practice location 4

10226 Couloak Dr
Ste 100
Charlotte, NC 28216-7675
Phone (704) 801-7380

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Ambulatory@direct.carolinashealthcare.org Atrium Health

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
I20070830000162 NC Practitioner - Emergency Medicine 2567555949 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007-00968NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince May 1, 2020 Accepting new patients
Carolinas Physicians Network Inc CurrentSince May 1, 2020 Accepting new patients
American Current Care of North Carolina, P.C. CurrentSince Mar 6, 2023 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince May 1, 2020 Accepting new patients
Emergency Medicine Physicians of Mecklenburg County, PLLC Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Davidson County, PLLC Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Iredell County, PLLC Emergency Medicine Past Accepting new patients

Locations

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

10226 Couloak Dr
Ste 100
Charlotte, NC 28216
Phone (704) 801-7380

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

101 E Wt Harris Blvd
Ste 5401
Charlotte, NC 28262
Phone (704) 863-1400

101 E Wt Harris Blvd
Ste 5002
Charlotte, NC 28262
Phone (704) 548-8724

10628 Park Rd
Charlotte, NC 28210
Phone (704) 543-2000

2001 Vail Ave
Charlotte, NC 28207
Phone (704) 304-5000

4221 Tuckaseegee Rd
Charlotte, NC 28208
Phone (704) 392-4057

16455 Statesville Rd
Ste 360
Huntersville, NC 28078
Phone (704) 801-3300

150 Professional Park Dr
Ste 400
Mooresville, NC 28117
Phone (704) 801-7350

557 Brookdale Dr
Statesville, NC 28677
Phone (330) 445-4361

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Interoperability endpoints

  • Direct secure messaging: ambulatory@direct.carolinashealthcare.org

Organizations & group practices 9

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1154463370",
    "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": "101 E WT HARRIS BLVD",
            "address_2": "STE 5002",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623485",
            "telephone_number": "704-801-7310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14214 Ballantyne Lake Rd",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773372",
            "country_code": "US",
            "telephone_number": "704-667-2650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 E W T Harris Blvd",
            "address_2": "Ste 5401",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623485",
            "country_code": "US",
            "telephone_number": "704-863-9700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Professional Park Dr",
            "address_2": "Ste 400",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281175603",
            "country_code": "US",
            "telephone_number": "704-801-7360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10226 Couloak Dr",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282167675",
            "country_code": "US",
            "telephone_number": "704-801-7380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "KELLYE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2007-00968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ambulatory@direct.carolinashealthcare.org",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "101 E Wt Harris Blvd",
            "address_2": "Ste 5002",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282623485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.