Individual provider Active NPI

Kira Mollenkopf Segebarth, RD, CPNP

  • Pediatric Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1295027845
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5005172 Issued in NC
Practice address
201 Queens Rd
Charlotte, NC 28204-3217
Phone
(704) 316-5910
NPI assigned
May 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 5005172 NC Primary

Addresses

Primary practice location

201 Queens Rd
Charlotte, NC 28204-3217

Mailing address

1900 Vernon Dr
Charlotte, NC 28211-1720
Phone (704) 960-9178

Other practice location 1

4501 Cameron Valley Pkwy
Suite 200
Charlotte, NC 28211-4297
Phone (704) 512-5836

Other identifiers 2

IdentifierTypeStateIssuer
7004940MedicaidNC
NP1835MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110817000582 NC Practitioner - Nurse Practitioner 5890964316 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 21, 2021 Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 21, 2021 Accepting new patients
Pediatric Endocrinology & Diabetes Specialists Past Accepting new patients
Pediatric Endocrinology & Diabetes Specialists PastSince Jan 19, 2020 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

201 Queens Rd
Charlotte, NC 28204
Phone (704) 316-5285

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: ksegebarth257136@direct.novanthealth.org

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": "1305244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1295027845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 VERNON DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111720",
            "telephone_number": "704-960-9178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 QUEENS RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043217",
            "telephone_number": "704-316-5910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4501 Cameron Valley Pkwy",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282114297",
            "country_code": "US",
            "telephone_number": "704-512-5836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEGEBARTH",
        "first_name": "KIRA",
        "middle_name": "MOLLENKOPF",
        "credential": "RD, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-13",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5005172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004940",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1835",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.