NPIMap

Individual provider Active NPI

Katherine M Card, PA

  • Medical Physician Assistant
  • Concord, NC
National Provider Identifier
1194976381
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-02010 Issued in NC
Practice address
5641 Poplar Tent Rd
Suite 101
Concord, NC 28027-7533
Phone
(704) 782-1955
Fax
(704) 782-3903
NPI assigned
Oct 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 012819 NY
Medical Physician Assistant 363AM0700X 0010-02010 NC Primary

Addresses

Primary practice location

5641 Poplar Tent Rd
Suite 101
Concord, NC 28027-7533

Mailing address

1601 Brenner Ave
Salisbury, NC 28144-2515
Phone (704) 796-2164

Other identifiers 3

IdentifierTypeStateIssuer
1532PAMedicaidSC
1194976381MedicaidNC
8102012MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-02010NCMDMedical Physician Assistant
012819NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Observation Medicine Physicians of Mecklenburg County PLLC Past Accepting new patients
Emergency Medicine Physicians of Iredell County, PLLC Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients

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": "1223251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1194976381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 BRENNER AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442515",
            "telephone_number": "704-796-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5641 POPLAR TENT RD",
            "address_2": "SUITE 101",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280277533",
            "telephone_number": "704-782-1955",
            "fax_number": "704-782-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARD",
        "first_name": "KATHERINE",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-06",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "012819",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-02010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1532PA",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194976381",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8102012",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.