Haley Marie McKissack, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

DR.0074792 Issued in NC

Practice address

1824 E Arbors Dr
Charlotte, NC 28262-2692

Phone

(704) 863-4878

NPI assigned

Apr 12, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Sports MedicineAlso: Orthopedic Surgery

Education

Florida International Univ, College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• University Physicians Incorporated

  • Internal Medicine Physician
  • Aurora, CO
  • NPI 1962461889

  Orthopaedic Surgery

  Medicare reassignment Care Compare group NPD
• University Physicians Incorporated

  • Physical Medicine & Rehabilitation Physician
  • Denver, CO
  • NPI 1265689053
  NPD
• University Physicians, Incorporated

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Denver, CO
  • NPI 1275045049
  NPD
• Carolinas Physicians Network Inc

  • Registered Dietitian
  • Huntersville, NC
  • NPI 1518405257

  Orthopaedic Surgery

  NPD (past)

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

{
    "created_epoch": "1586649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1275152019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 E ARBORS DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282622692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 E ARBORS DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282622692",
            "telephone_number": "704-863-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKISSACK",
        "first_name": "HALEY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-12",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "DR.0074792",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NC",
            "license": "DR.0074792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia McKinney
• Parker Wallace McKinnon, R.D.
• Samantha Sage McKinnon
• Alexandra Riehm McKinsey, P.A.
• Robert L McKinstry
• Kamilah McPhail McKissick, PSY.D.
• Nora McKiver
• Lauren McKnight-Ford, RD
• Cynthia Michelle McKnight, LPCA
• Dorothy McKnight, LCSW

• Sports Medicine (Orthopaedic Surgery) Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.