Kendra Jo Back, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5021586 Issued in NC

Practice address

448 Cranberry St
Newland, NC 28657-8800

Phone

(828) 737-0221

Fax

(828) 737-0321

NPI assigned

Aug 29, 2012

Last updated

Dec 9, 2025By 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 9

Addresses

Other identifiers 6

Other names 1

• Kendra Jo Edwards Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL, CO, GA, TN, NC5 enrollments

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 5

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brightside Medical PCGroup PAC ID 6608262464, 274 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JJJEBD
• Direct secure messaging: kendra.back.1@4692.direct.athenahealth.com

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.

• Brightside Medical, P.C.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1801355482

  TN

  Medicare reassignment Care Compare group NPD
• High Country Community Health

  • Federally Qualified Health Center (FQHC)
  • Newland, NC
  • NPI 1083979082

  Family

  Medicare reassignment NPD
• Hillcrest Clinic, LLC

  dba Hillcrest Clinic & Imaging

  • Family Medicine Physician
  • Blairsville, GA
  • NPI 1831370188
  Medicare reassignment NPD
• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000

  Family

  Medicare reassignment NPD
• Peak Vista Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1730166034
  Medicare reassignment NPD
• Rural Urgent Care LLC

  • Urgent Care Clinic/Center
  • Centre, AL
  • NPI 1932586476

  GA

  Medicare reassignment NPD
• High Country Community Health

  • Federally Qualified Health Center (FQHC)
  • Mount Airy, NC
  • NPI 1629942115
  NPD
• MCR Health, Inc.

  dba Riverside Medical Center

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD
• Peak Vista Community Health Centers

  dba Behavioral Health at Inside Out Youth Services

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1871347443
  NPD
• Rural Urgent Care LLC

  dba MainStreet Family Care

  • Rural Health Clinic/Center
  • Eufaula, AL
  • NPI 1588450316
  NPD

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1437408093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1490",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286070682",
            "telephone_number": "828-262-3886",
            "fax_number": "833-665-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 CRANBERRY ST",
            "city": "NEWLAND",
            "state": "NC",
            "postal_code": "286578800",
            "telephone_number": "828-737-0221",
            "fax_number": "828-737-0321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 Highway 105 Ext Ste 100",
            "address_purpose": "LOCATION",
            "city": "Boone",
            "state": "NC",
            "postal_code": "286074291",
            "country_code": "US",
            "telephone_number": "828-264-7311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "935 State Farm Rd",
            "address_purpose": "LOCATION",
            "city": "Boone",
            "state": "NC",
            "postal_code": "286074948",
            "country_code": "US",
            "telephone_number": "828-262-3886",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 E Meeting St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Morganton",
            "state": "NC",
            "postal_code": "286553594",
            "country_code": "US",
            "telephone_number": "828-608-0800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Manatee Ave W",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342058604",
            "country_code": "US",
            "telephone_number": "941-748-3065",
            "fax_number": "941-748-8620",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "562 Fall Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Blountville",
            "state": "TN",
            "postal_code": "376174803",
            "country_code": "US",
            "telephone_number": "239-834-7601",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "560 Malcolm Blvd",
            "address_purpose": "LOCATION",
            "city": "Connelly Springs",
            "state": "NC",
            "postal_code": "286127918",
            "country_code": "US",
            "telephone_number": "828-874-2061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Dutchman Ct",
            "address_purpose": "LOCATION",
            "city": "Elkin",
            "state": "NC",
            "postal_code": "286212237",
            "country_code": "US",
            "telephone_number": "336-835-7737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACK",
        "first_name": "KENDRA",
        "middle_name": "JO",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9212674",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5021586",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "28417",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0991706-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "28417",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209031861",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN9212674",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "041572779",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN297601",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF GA APRN LICENSE",
            "identifier": "297601",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF IL APRN LICENSE",
            "identifier": "041572779",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NC APRN",
            "identifier": "5021586",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65122071",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA ARNP LICENSE",
            "identifier": "ARNP9212674",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE-BCBS",
            "identifier": "Y0EZQ",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kendra.back.1@4692.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "701 Manatee Ave W",
            "city": "Bradenton",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342058604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KENDRA",
            "last_name": "EDWARDS",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Avery Association for Exceptional Citizens, Inc. (Avery County Group Home)
• Avery County Department of Social Services
• Avery County Schools
• Avery Eye Care Center
• Avery Wellness PLLC (Avery Wellness)
• Lynn Worley Bailey, OTR/L
• Terylee Banwart, LPC
• Emily Maye Beck, PHARMD
• Emily Faye Benfield, FNP
• Rosa Marie Benfield, FNP

• Family Nurse Practitioner in Newland, NC
• Providers in Newland, 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 Dec 9, 2025; 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.