Individual provider Active NPI

Kelsey Elizabeth Dolman, PA

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1295510477
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-13747 Issued in NC
Practice address
1237 Harding PL
Ste 3100
Charlotte, NC 28204
Phone
(704) 373-0212
NPI assigned
Aug 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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 0010-13747 NC Primary

Addresses

Primary practice location

1237 Harding PL
Ste 3100
Charlotte, NC 28204

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

100 Medical Park Dr
Ste 210
Concord, NC 28025-2948
Phone (704) 403-6100

Other practice location 2

447 McAlister Rd
Ste 3200
Lincolnton, NC 28092-4114
Phone (980) 212-6300

Other practice location 3

101 E W T Harris Blvd
Ste 1213
Charlotte, NC 28262-3485
Phone (704) 863-1950

Other practice location 4

10650 Park Rd
Charlotte, NC 28210-8538
Phone (704) 667-3840

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address kdolman2848113@CarolinasHealthcareSystem.direct-ci.com Atrium Health

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
I20240311000284 NC Practitioner - Physician Assistant 2567808728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000

134 Medical Park Rd
Suite 111
Mooresville, NC 28117-8527
Phone (704) 801-9100

600 Hospital Dr
Monroe, NC 28112-6000
Phone (704) 283-3100

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Atrium Health Cleveland Hospital, Shelby, NC, CCN 340021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-13747NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Mar 25, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Mar 25, 2024 Accepting new patients

Locations

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

1237 Harding Pl
Ste 3100
Charlotte, NC 28204

101 E Wt Harris Blvd
Ste 1213
Charlotte, NC 28262
Phone (704) 863-1950

10650 Park Rd
Charlotte, NC 28210
Phone (704) 667-0337

100 Medical Park Dr
Ste 210
Concord, NC 28025
Phone (704) 403-6100

447 McAlister Rd
Ste 3200
Lincolnton, NC 28092
Phone (980) 212-6300

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

Interoperability endpoints

  • Direct secure messaging: kdolman2848113@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 3

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 7

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": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1295510477",
    "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": "1237 HARDING PL",
            "address_2": "STE 3100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28204",
            "telephone_number": "704-373-0212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Medical Park Dr",
            "address_2": "Ste 210",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252948",
            "country_code": "US",
            "telephone_number": "704-403-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "447 McAlister Rd",
            "address_2": "STE 3200",
            "address_purpose": "LOCATION",
            "city": "Lincolnton",
            "state": "NC",
            "postal_code": "280924114",
            "country_code": "US",
            "telephone_number": "980-212-6300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 E W T Harris Blvd",
            "address_2": "Ste 1213",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623485",
            "country_code": "US",
            "telephone_number": "704-863-1950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10650 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108538",
            "country_code": "US",
            "telephone_number": "704-667-3840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOLMAN",
        "first_name": "KELSEY",
        "middle_name": "ELIZABETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2024-07-23",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "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"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdolman2848113@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1237 Harding Pl",
            "address_2": "Ste 3100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.