Individual provider Active NPI

Kendra Kamera Ham, MD

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1285955435
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2017-02026 Issued in NC
Practice address
901 East Blvd
Charlotte, NC 28203-5203
Phone
(704) 355-6560
NPI assigned
Jun 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child Abuse Pediatrics Physician 2080C0008X 2017-02026 NC
Pediatrics Physician 208000000X 2017-02026 NC Primary

Addresses

Primary practice location

901 East Blvd
Charlotte, NC 28203-5203

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

2550 Court Dr
Gastonia, NC 28054-2152
Phone (704) 381-8840

Other practice location 2

1001 Blythe Blvd
Medical Center Plaza, Suite 200
Charlotte, NC 28203-5866
Phone (704) 381-8840

Other practice location 3

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-1422

Other practice location 4

14214 Ballantyne Lake Rd
Charlotte, NC 28277-3372
Phone (704) 381-8840

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kham164904@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171114003603 NC Practitioner - Pediatric Medicine 9032331608 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017-02026NCMDChild Abuse Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center Pediatrics CurrentSince Oct 1, 2017 Accepting new patients
Carolinas Medical Center CurrentSince Oct 1, 2017 Accepting new patients
Carolinas Medical Center Pediatrics Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Pediatrics CurrentSince Jan 20, 2020 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jan 20, 2020 Accepting new patients

Locations

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

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

1001 Blythe Blvd
Ste 200
Charlotte, NC 28203
Phone (704) 373-0544

14214 Ballantyne Lake Rd
Charlotte, NC 28277
Phone (704) 667-2600

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

901 East Blvd
Charlotte, NC 28203
Phone (704) 335-2763

2550 Court Dr
Gastonia, NC 28054
Phone (252) 773-0195

Interoperability endpoints

  • Direct secure messaging: kham164904@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.

NPI Registry JSON

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1285955435",
    "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": "901 EAST BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035203",
            "telephone_number": "704-355-6560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 Court Dr",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280542152",
            "country_code": "US",
            "telephone_number": "704-381-8840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 Blythe Blvd",
            "address_2": "Medical Center Plaza, Suite 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035866",
            "country_code": "US",
            "telephone_number": "704-381-8840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-1422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14214 Ballantyne Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773372",
            "country_code": "US",
            "telephone_number": "704-381-8840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAM",
        "first_name": "KENDRA",
        "middle_name": "KAMERA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-22",
        "last_updated": "2024-07-15",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080C0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Child Abuse Pediatrics",
            "state": "NC",
            "license": "2017-02026",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2017-02026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kham164904@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "901 East Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282035203",
            "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.