NPIMap

Individual provider Active NPI

Anita Afriyie Kisiedu, MD

  • Family Medicine Physician
  • Harrisburg, NC
National Provider Identifier
1245851922
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2023-02197 Issued in NC
Practice address
6555 Kee LN Ste 200
Harrisburg, NC 28075-7463
Phone
(980) 302-9840
Fax
(980) 302-9841
NPI assigned
May 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2023-02197 NC Primary

Addresses

Primary practice location

6555 Kee LN Ste 200
Harrisburg, NC 28075-7463

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

1993 Harrison St
Batesville, AR 72501-7309
Phone (703) 586-2810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230815001688 NC Practitioner - Family Practice 3173985611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

6555 Kee LN
Suite 200
Harrisburg, NC 28075-7463
Phone (980) 302-9840

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 7, 2023 Accepting new patients
Novant Health Medical Group, LLC Family Medicine CurrentSince Jul 7, 2023 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

6555 Kee Ln
Ste 200
Harrisburg, NC 28075
Phone (704) 316-2319

1035 Dale Earnhardt Blvd
Kannapolis, NC 28083
Phone (704) 316-1886

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: akisiedu1134606@direct.novanthealth.org

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.

Hospital & facility affiliations 8

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": "1588550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1245851922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6555 KEE LN STE 200",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280757463",
            "telephone_number": "980-302-9840",
            "fax_number": "980-302-9841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1993 Harrison St",
            "address_purpose": "LOCATION",
            "city": "Batesville",
            "state": "AR",
            "postal_code": "725017309",
            "country_code": "US",
            "telephone_number": "703-586-2810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISIEDU",
        "first_name": "ANITA",
        "middle_name": "AFRIYIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-04",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2023-02197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, NC

Sources for this page

Verify at the official NPI Registry.