Individual provider Active NPI

Kimberly Anne Friesema, PA

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1275924755
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-05581 Issued in NC
Practice address
125 Queens Rd Ste 330
Charlotte, NC 28204-3419
Phone
(704) 384-5043
Fax
(704) 384-8895
NPI assigned
Feb 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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 0010-05581 NC Primary

Addresses

Primary practice location

125 Queens Rd Ste 330
Charlotte, NC 28204-3419

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-5043

Other practice location 1

4525 Cameron Valley Pkwy
Charlotte, NC 28211-4369
Phone (704) 355-5100

Other practice location 2

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-0720

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kfriesema136975@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

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
I20150509000408 NC Practitioner - Physician Assistant 7012236268 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
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, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

125 Queens Rd
Charlotte, NC 28204-3215

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-05581NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center CurrentSince Apr 6, 2015 Accepting new patients
Columbus Regional Health Network CurrentSince Apr 6, 2015 Accepting new patients
The Presbyterian Hospital CurrentSince May 19, 2023 Accepting new patients
Novant Medical Group, Inc. CurrentSince May 19, 2023 Accepting new patients
Scotland Regional Health Network CurrentSince Apr 6, 2015 Accepting new patients
Carolinas Medical Center CurrentSince Apr 6, 2015 Accepting new patients
Carolinas Physicians Network Inc Hospitalist CurrentSince Apr 6, 2015 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Apr 6, 2015 Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 19, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 19, 2023 Accepting new patients
The Presbyterian Hospital CurrentSince May 19, 2023 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients
Columbus Regional Health Network Past Accepting new patients

Locations

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

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

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

125 Queens Rd
Ste 330
Charlotte, NC 28204
Phone (704) 384-5043

1001 Blythe Blvd
Ste 500
Charlotte, NC 28203
Phone (704) 355-5100

125 Baldwin Ave
Ste 200
Charlotte, NC 28204
Phone (704) 384-5043

4525 Cameron Valley Pkwy
Charlotte, NC 28211
Phone (704) 355-5100

301 Hawthorne Ln
Ste 200
Charlotte, NC 28204
Phone (704) 316-5100

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

10545 Blair Rd
Ste 200
Mint Hill, NC 28227
Phone (704) 863-9500

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

612 Jefferson St
#28
Whiteville, NC 28472
Phone (910) 640-4064

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

Interoperability endpoints

  • Direct secure messaging: kfriesema136975@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: kfriesema1136404@direct.novanthealth.org

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 4

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": "1423094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1275924755",
    "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",
            "telephone_number": "704-384-5043",
            "fax_number": "704-384-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD STE 330",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043419",
            "telephone_number": "704-384-5043",
            "fax_number": "704-384-8895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4525 Cameron Valley Pkwy",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282114369",
            "country_code": "US",
            "telephone_number": "704-355-5100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Blythe Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035812",
            "country_code": "US",
            "telephone_number": "704-355-0720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRIESEMA",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-05",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-05581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kfriesema136975@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "4525 Cameron Valley Pkwy",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282114369",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.