Individual provider Active NPI

Carly Holst

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1396483483
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5016310 Issued in NC
Practice address
4100 Carmel Rd
Charlotte, NC 28226-6150
Phone
(704) 542-9210
NPI assigned
May 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5016310 NC Primary

Addresses

Primary practice location

4100 Carmel Rd
Charlotte, NC 28226-6150

Mailing address

4100 Carmel Rd
Charlotte, NC 28226-6150

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
I20220816001181 NC Practitioner - Nurse Practitioner 6608259163 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of North Carolina PCGroup PAC ID 6002837572, 208 clinicians

Practice addresses (Care Compare)

4100 Carmel Rd
Charlotte, NC 28226-6150
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Primary Care North Carolina PLLC Family CurrentSince Aug 7, 2025 Accepting new patients
Minuteclinic Diagnostic of North Carolina PC Family CurrentSince Jul 11, 2022 Accepting new patients

Locations

10100 S Main St
Archdale, NC 27263
Phone (336) 431-0715

4100 Carmel Rd
Charlotte, NC 28226
Phone (704) 542-1806

1305 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 846-7651

2340 Spring Forest Rd
Raleigh, NC 27615
Phone (919) 790-6401

6840 Glenwood Ave
Raleigh, NC 27612
Phone (401) 770-4415

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

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": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1396483483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 CARMEL RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282266150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 CARMEL RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282266150",
            "telephone_number": "704-542-9210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLST",
        "first_name": "CARLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5016310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.