Kaitlin Marie Fagan, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5019669 Issued in NC

Practice address

4100 Carmel Rd
Charlotte, NC 28226-6150

Phone

(704) 542-9210

NPI assigned

Feb 27, 2024

Last updated

Mar 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

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)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

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

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.

• Minuteclinic Diagnostic of North Carolina PC

  • Family Nurse Practitioner
  • Raleigh, NC
  • NPI 1699748608
  Medicare reassignment Care Compare group NPD
• Minuteclinic Primary Care North Carolina PLLC

  • Family Nurse Practitioner
  • Raleigh, NC
  • NPI 1356159818
  Medicare reassignment NPD

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

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1396501391",
    "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",
            "telephone_number": "704-542-9210"
        },
        {
            "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": "FAGAN",
        "first_name": "KAITLIN",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5019669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Fadel, LCMHCA
• Yonis Mohamed Ahmed Fadlalmula
• Fafli Inc
• David Fafore, LCSW-A
• James Arthur Fagan, M.D.
• Lavina Rae Fagan
• Elizabeth Shields Fagg, M.S.
• Lester J. Fahrner IV, MD, MS
• Christopher Randall Fahrney, DMD
• Jordan Andrew Failla, DO

• Family Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.