Individual provider Active NPI

Kristen McKellar Zieminski

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1215565577
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1011691 Issued in NC
Practice address
16704 Hawfield Way Dr
Charlotte, NC 28277-6132
Phone
(704) 337-0221
NPI assigned
Mar 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1011691 NC Primary

Addresses

Primary practice location

16704 Hawfield Way Dr
Charlotte, NC 28277-6132

Mailing address

1025 Peerless Xing NW
Cleveland, TN 37312-3764
Phone (423) 476-5990

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230104000537 NC Practitioner - Physician Assistant 9436589389 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Afc Urgent Care and Family Care of WNC PLLCGroup PAC ID 2567713332, 75 clinicians

Practice addresses (Care Compare)

10102 Johnston Rd
Charlotte, NC 28210-8203
Phone (704) 247-6578

16704 Hawfield Way Dr
Charlotte, NC 28277-6132
Phone (704) 337-0221

440 Tyvola Rd
Charlotte, NC 28217-3560
Phone (704) 228-1784

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Services Past Accepting new patients
First Care Medical Clinic, PA PastSince Mar 12, 2024 Accepting new patients

Organizations & group practices 4

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": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1215565577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 PEERLESS XING NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123764",
            "telephone_number": "423-476-5990",
            "fax_number": "423-476-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16704 HAWFIELD WAY DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282776132",
            "telephone_number": "704-337-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIEMINSKI",
        "first_name": "KRISTEN",
        "middle_name": "MCKELLAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2024-03-07",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "1011691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.