NPIMap

Individual provider Active NPI

Kevin Christopher Coughlin, M.D.

  • Otolaryngology Physician
  • Charlotte, NC
National Provider Identifier
1306297841
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
2023-00810 Issued in NC
Practice address
13532 Steelecroft Pkwy
Charlotte, NC 28278-7545
Phone
(704) 295-3475
Fax
(704) 295-3476
NPI assigned
Jun 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 66570 TN
Sleep Medicine (Otolaryngology) Physician 207YS0012X 2023-00810 NC
Sleep Medicine (Otolaryngology) Physician 207YS0012X 66570 TN
Otolaryngology Physician 207Y00000X 2023-00810 NC Primary

Addresses

Primary practice location

13532 Steelecroft Pkwy
Charlotte, NC 28278-7545

Mailing address

6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000

Other practice location 1

6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000

Other practice location 2

400 Park St
Belmont, NC 28012-3368
Phone (704) 295-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230908000168 NC Practitioner - Otolaryngology 3375810682 Reassigns benefits to 1 organization
I20230908000227 SC Practitioner - Otolaryngology 3375810682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Tennessee, HSC, College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13532 Steelecroft Pkwy
Charlotte, NC 28278-7545
Phone (704) 295-3475

601 Sutton Rd S
Suite 201
Fort Mill, SC 29715-8439
Phone (803) 547-3800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023-00810NCMDSleep Medicine (Otolaryngology) Physician
66570TNMDSleep Medicine (Otolaryngology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Eye Ear Nose & Throat Associates, PA CurrentSince Aug 29, 2023 Accepting new patients
Charlotte Eye Ear Nose & Throat Associates, P.a. Otolaryngology CurrentSince Aug 29, 2023 Accepting new patients

Locations

400 Park St
Belmont, NC 28012
Phone (704) 295-3700

6035 Fairview Rd
Charlotte, NC 28210
Phone (336) 718-2078

13532 Steelecroft Pkwy
Charlotte, NC 28278
Phone (704) 295-3475

601 Sutton Rd S
Ste 201
Fort Mill, SC 29715
Phone (803) 328-1864

200 Herlong Ave S
Ste A
Rock Hill, SC 29732
Phone (803) 324-1028

Interoperability endpoints

  • Direct secure messaging: kcoughlin38109@direct.ceenta.com
  • Direct secure messaging: kcoughlin2704744@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 2

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1306297841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6035 FAIRVIEW RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103256",
            "telephone_number": "704-295-3000",
            "fax_number": "704-295-3468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13532 STEELECROFT PKWY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282787545",
            "telephone_number": "704-295-3475",
            "fax_number": "704-295-3476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6035 Fairview Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282103256",
            "country_code": "US",
            "telephone_number": "704-295-3000",
            "fax_number": "704-295-3468",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Park St",
            "address_purpose": "LOCATION",
            "city": "Belmont",
            "state": "NC",
            "postal_code": "280123368",
            "country_code": "US",
            "telephone_number": "704-295-3700",
            "fax_number": "704-295-3707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COUGHLIN",
        "first_name": "KEVIN",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-27",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TN",
            "license": "66570",
            "primary": false
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "NC",
            "license": "2023-00810",
            "primary": false
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "TN",
            "license": "66570",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "2023-00810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.