Individual provider Active NPI

Tshikwakwa Kasembwe, FNP-BC

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1326877572
Registry record updated Jul 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5020526 Issued in NC
Practice address
537 W Sugar Creek Rd Ste 201
Charlotte, NC 28213-6103
Phone
(704) 979-8210
NPI assigned
Jul 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5020526 NC Primary

Addresses

Primary practice location

537 W Sugar Creek Rd Ste 201
Charlotte, NC 28213-6103

Mailing address

537 West Sugar Creek Rd # 201
Charlotte, NC 28213
Phone (704) 222-5528

Other names 1

  • N/a N/a Professional name

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
I20250221000765 NC Practitioner - Nurse Practitioner 5991225948 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5020526NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Theoria Medical Nurse Practitioner CurrentSince Oct 16, 2024 Accepting new patients
Theoria Medical Nurse Practitioner Past Accepting new patients

Locations

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

515 S Generals Blvd
Lincolnton, NC 28092
Phone (704) 733-8065

430 W Health Center Dr
Nags Head, NC 27959
Phone (252) 441-3116

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.

NPI Registry JSON

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

{
    "created_epoch": "1722038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722038400000",
    "number": "1326877572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "537 WEST SUGAR CREEK RD # 201",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28213",
            "telephone_number": "704-222-5528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 W SUGAR CREEK RD STE 201",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282136103",
            "telephone_number": "704-979-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASEMBWE",
        "first_name": "TSHIKWAKWA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-27",
        "last_updated": "2024-07-27",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5020526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N/A",
            "last_name": "N/A",
            "credential": "FNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.