Individual provider Active NPI

Katherine Cyran Van Poppel, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Concord, NC
National Provider Identifier
1194925396
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
2013-01776 Issued in NC
Practice address
100 Medical Park Dr
Suite 310
Concord, NC 28025-2948
Phone
(704) 403-2660
NPI assigned
Jul 25, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X 2013-01776 NC
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 2013-01776 NC Primary

Addresses

Primary practice location

100 Medical Park Dr
Suite 310
Concord, NC 28025-2948

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

2550 Court Dr
Ste 203
Gastonia, NC 28054-2152
Phone (704) 381-1450

Other practice location 2

6600 W Wilkinson Blvd
Belmont, NC 28012-2796
Phone (704) 381-1450

Other practice location 3

9625 Northcross Center Ct
Ste 102B
Huntersville, NC 28078-7348
Phone (704) 801-1240

Other practice location 4

1001 Blythe Blvd
Medical Center Plaza, Suite 200
Charlotte, NC 28203-5866
Phone (704) 381-8840

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kvanpoppel137026@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
I20220524001684 NC Practitioner - Neurology 0840468849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Indiana University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Charlotte-Mecklenburg Hospital AuthorityGroup PAC ID 2961310685, 594 clinicians

Practice addresses (Care Compare)

100 Medical Park Dr
Suite 110
Concord, NC 28025-2966
Phone (704) 403-1370

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

State licenses

LicenseStateTypeSpecialty
46502TNMDPharmacist
2013-01776NCMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Apr 2, 2022 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Neurology CurrentSince Apr 2, 2022 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients

Locations

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

1001 Blythe Blvd
Ste 200
Charlotte, NC 28203
Phone (704) 373-0544

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

100 Medical Park Dr
Ste 310
Concord, NC 28025
Phone (704) 403-2860

Interoperability endpoints

  • Direct secure messaging: kvanpoppel137026@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": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1194925396",
    "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": "100 MEDICAL PARK DR",
            "address_2": "SUITE 310",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252948",
            "telephone_number": "704-403-2660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 Court Dr",
            "address_2": "Ste 203",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280542152",
            "country_code": "US",
            "telephone_number": "704-381-1450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6600 W Wilkinson Blvd",
            "address_purpose": "LOCATION",
            "city": "Belmont",
            "state": "NC",
            "postal_code": "280122796",
            "country_code": "US",
            "telephone_number": "704-381-1450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9625 Northcross Center Ct",
            "address_2": "Ste 102B",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787348",
            "country_code": "US",
            "telephone_number": "704-801-1240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 Blythe Blvd",
            "address_2": "Medical Center Plaza, Suite 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035866",
            "country_code": "US",
            "telephone_number": "704-381-8840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN POPPEL",
        "first_name": "KATHERINE",
        "middle_name": "CYRAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-25",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NC",
            "license": "2013-01776",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NC",
            "license": "2013-01776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kvanpoppel137026@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "100 Medical Park Dr",
            "address_2": "Suite 310",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252948",
            "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 Concord, NC

Sources for this page

Verify at the official NPI Registry.