Individual provider Active NPI

Kelley Howard Rouse, MD

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
National Provider Identifier
1245349497
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2006-01097 Issued in NC
Practice address
9908 Couloak Dr
Ste 201
Charlotte, NC 28216-8678
Phone
(704) 801-2075
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2006-01097 NC Primary

Addresses

Primary practice location

9908 Couloak Dr
Ste 201
Charlotte, NC 28216-8678

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

101 E W T Harris Blvd
Ste 2320
Charlotte, NC 28262-3485
Phone (704) 547-0858

Other practice location 2

7810 Providence Rd
Ste 105
Charlotte, NC 28226-2954
Phone (704) 446-7800

Other practice location 3

6030 W Highway 74
Ste B
Indian Trail, NC 28079-3468
Phone (704) 446-7800

Other practice location 4

1025 Morehead Medical Dr
Ste 500 FL 5
Charlotte, NC 28204-2963
Phone (704) 355-3149

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address krouse128656@CarolinasHealthcareSystem.direct-ci.com 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
I20070109000548 NC Practitioner - Obstetrics/Gynecology 4688646177 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Emory University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

1025 Morehead Medical Dr
Charlotte, NC 28204-2963
Phone (704) 446-7800

14214 Ballantyne Lake Rd
Charlotte, NC 28277-3373

1443 S Blvd
Charlotte, NC 28203-4211
Phone (704) 446-1700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006-01097NCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center Obstetrics & Gynecology CurrentSince Sep 5, 2024 Accepting new patients
Carolinas Medical Center Obstetrics & Gynecology Current Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jun 5, 2019 Accepting new patients
Carolinas Medical Center CurrentSince Sep 5, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jun 5, 2019 Accepting new patients

Locations

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

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

1023 Edgehill Rd S
Charlotte, NC 28207
Phone (704) 355-8686

9908 Couloak Dr
Ste 201
Charlotte, NC 28216
Phone (704) 801-2075

1025 Morehead Medical Dr
Ste 400
Charlotte, NC 28204

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1025 Morehead Medical Dr
Ste 500
Charlotte, NC 28204
Phone (704) 355-3149

7810 Providence Rd
Ste 105
Charlotte, NC 28226
Phone (704) 446-7800

1025 Morehead Medical Dr
Ste 525
Charlotte, NC 28204
Phone (704) 355-3149

101 E Wt Harris Blvd
Ste 2320
Charlotte, NC 28262
Phone (704) 547-0858

16455 Statesville Rd
Ste 400
Huntersville, NC 28078
Phone (701) 801-2130

6030 W Highway 74
Ste B
Indian Trail, NC 28079
Phone (704) 289-2553

Interoperability endpoints

  • Direct secure messaging: krouse128656@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1245349497",
    "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": "9908 COULOAK DR",
            "address_2": "STE 201",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282168678",
            "telephone_number": "704-801-2075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E W T Harris Blvd",
            "address_2": "Ste 2320",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623485",
            "country_code": "US",
            "telephone_number": "704-547-0858",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7810 Providence Rd",
            "address_2": "Ste 105",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282262954",
            "country_code": "US",
            "telephone_number": "704-446-7800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6030 W Highway 74",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "Indian Trail",
            "state": "NC",
            "postal_code": "280793468",
            "country_code": "US",
            "telephone_number": "704-446-7800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 Morehead Medical Dr",
            "address_2": "Ste 500 FL 5",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042963",
            "country_code": "US",
            "telephone_number": "704-355-3149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROUSE",
        "first_name": "KELLEY",
        "middle_name": "HOWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-05-04",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2006-01097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "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"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krouse128656@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "9908 Couloak Dr",
            "address_2": "Ste 201",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282168678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.