Individual provider Active NPI

Karen Suzanne Holst, MSW, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1376676601
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C004106 Issued in NC
Practice address
6324 Fairview Rd Ste 460
Charlotte, NC 28210-3271
Phone
(980) 302-8611
Fax
(980) 302-8624
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C004106 NC Primary

Addresses

Primary practice location

6324 Fairview Rd Ste 460
Charlotte, NC 28210-3271

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (980) 302-8611

Other practice location 1

5700 Executive Center Dr
Suite 110
Charlotte, NC 28212-8858
Phone (704) 986-1500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kholst815751@direct.novanthealth.org

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140516002044 NC Practitioner - Clinical Social Worker 4789807876 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Nova Southeastern Univ College of Dental Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

6324 Fairview Rd
Suite 460
Charlotte, NC 28210-3271
Phone (980) 302-8611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Monarch CurrentSince Feb 18, 2014 Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 22, 2020 Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 22, 2020 Accepting new patients
Monarch Current Accepting new patients
Monarch CurrentSince Feb 18, 2014 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients

Locations

350 Pee Dee Ave
Ste 101
Albemarle, NC 28001
Phone (704) 986-1522

1900 Randolph Rd
Ste 800
Charlotte, NC 28207
Phone (704) 941-4171

6324 Fairview Rd
Ste 460
Charlotte, NC 28210
Phone (980) 302-8611

13815 Professional Center Dr
Ste 100
Huntersville, NC 28078
Phone (704) 316-2050

820 Grimes Blvd
Lexington, NC 27292
Phone (336) 224-6071

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: kholst815751@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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1376676601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "980-302-8611",
            "fax_number": "980-302-8624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6324 FAIRVIEW RD STE 460",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103271",
            "telephone_number": "980-302-8611",
            "fax_number": "980-302-8624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5700 Executive Center Dr",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282128858",
            "country_code": "US",
            "telephone_number": "704-986-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLST",
        "first_name": "KAREN",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-10-27",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kholst815751@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "5700 Executive Center Dr",
            "address_2": "Suite 110",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282128858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.