Individual provider Active NPI

Kamla Terese Jain, MD

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1235208018
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2000-00471 Issued in NC
Practice address
309 S Sharon Amity Rd
Suite 100
Charlotte, NC 28211-2978
Phone
(704) 446-2360
Fax
(704) 366-3746
NPI assigned
Nov 7, 2006
Last updated
Sep 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 200000471 NC
Family Medicine Physician 207Q00000X 2000-00471 NC Primary

Addresses

Primary practice location

309 S Sharon Amity Rd
Suite 100
Charlotte, NC 28211-2978

Mailing address

Asu Student Health Center
614 Howard Street, Miles Annas BLDG
Boone, NC 28608
Phone (704) 446-2360

Other identifiers 4

IdentifierTypeStateIssuer
0106165OtherNCUNITED HEALTH CARE
8912545MedicaidNC
6833648OtherNCCIGNA
12545OtherNCBLUE CROSS BLUE SHIELD

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
I20051116000123 NC Practitioner - Family Practice 6800877614 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2000-00471NCMDFamily Medicine Physician
200000471NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Regional Medical Associates, Inc. Family Medicine CurrentSince Mar 15, 2019 Accepting new patients
Carolinas Physicians Network Inc Family Medicine Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Transylvania Community Hospital, Inc Past Accepting new patients
MHS Primary Care Inc Family Medicine Past Accepting new patients
Medical Associates of Transylvania PA Family Medicine Past Accepting new patients
Cabarrus Urgent Care Family Medicine Past Accepting new patients
Transylvania Community Hospital, Inc. Family Medicine Past Accepting new patients

Locations

211 Milton Brown Heirs Rd
Boone, NC 28607
Phone (828) 264-6720

2146 Blowing Rock Rd
Boone, NC 28607
Phone (828) 265-5505

336 Deerfield Rd
Boone, NC 28607
Phone (828) 263-1211

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1235208018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ASU STUDENT HEALTH CENTER",
            "address_2": "614 HOWARD STREET, MILES ANNAS BLDG",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "28608",
            "telephone_number": "704-446-2360",
            "fax_number": "704-366-3746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 S SHARON AMITY RD",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112978",
            "telephone_number": "704-446-2360",
            "fax_number": "704-366-3746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "KAMLA",
        "middle_name": "TERESE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200000471",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2000-00471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "0106165",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8912545",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6833648",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "12545",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.