Individual provider Active NPI

Afnan M Kadah, PA-C

  • Physician Assistant
  • Concord, NC
National Provider Identifier
1306515820
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-11714 Issued in NC
Practice address
611 Church St N
Concord, NC 28025-4322
Phone
(704) 963-9270
Fax
(704) 963-9038
NPI assigned
Sep 8, 2021
Last updated
Nov 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-11714 NC Primary
Medical Physician Assistant 363AM0700X 0010-11714 NC

Addresses

Primary practice location

611 Church St N
Concord, NC 28025-4322

Mailing address

611 Church St N
Concord, NC 28025-4322
Phone (980) 866-0466

Other identifiers 1

IdentifierTypeStateIssuer
0010-11714OtherNCNORTH CAROLINA MEDICAL BOARD

Other names 1

  • Afnan M Beauti Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@rowanpsychiatric.com Direct

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
I20220112001687 NC Practitioner - Physician Assistant 8123410693 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rowan Psychiatric and Medical Services PAGroup PAC ID 1557542123, 10 clinicians

Practice addresses (Care Compare)

117 Fuchia LN
Lincolnton, NC 28092-4287
Phone (704) 520-3620

310 Statesville Blvd
Salisbury, NC 28144-2368
Phone (704) 637-1888

611 Church St N
Concord, NC 28025-4322
Phone (704) 963-9270

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-11714NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
First Care Medical Clinic CurrentSince Oct 13, 2021 Accepting new patients

Locations

2938 The Plaza
Charlotte, NC 28205
Phone (704) 375-0404

404 S Sutherland Ave
Monroe, NC 28112

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1306515820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280254322",
            "telephone_number": "980-866-0466",
            "fax_number": "704-963-9038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280254322",
            "telephone_number": "704-963-9270",
            "fax_number": "704-963-9038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADAH",
        "first_name": "AFNAN",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-08",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11714",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-11714",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA MEDICAL BOARD",
            "identifier": "0010-11714",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@rowanpsychiatric.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "611 Church St N",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280254322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AFNAN",
            "last_name": "BEAUTI",
            "middle_name": "M",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.