Individual provider Active NPI

Krystin Brooke Hepburn, AGNP-C

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1437708310
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5012249 Issued in NC
Practice address
125 Queens Rd Ste 400
Charlotte, NC 28204-3215
Phone
(980) 302-6400
Fax
(980) 302-6405
NPI assigned
Sep 4, 2019
Last updated
Jul 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5012249 NC Primary
Adult Health Nurse Practitioner 363LA2200X 258915 NC
Gerontology Nurse Practitioner 363LG0600X 258915 NC

Addresses

Primary practice location

125 Queens Rd Ste 400
Charlotte, NC 28204-3215

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

10905 Providence Rd W Ste 150
Charlotte, NC 28277-1538
Phone (980) 302-7120

Other identifiers 1

IdentifierTypeStateIssuer
1437708310MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL khepburn845464@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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191212002005 NC Practitioner - Nurse Practitioner 0547693129 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Presbyterian HospitalGroup PAC ID 1153231907, 412 clinicians

Practice addresses (Care Compare)

125 Queens Rd
Suite 400
Charlotte, NC 28204-3215
Phone (980) 302-6400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
258915NCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Presbyterian Hospital Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Dec 1, 2021 Accepting new patients
The Presbyterian Hospital CurrentSince Dec 1, 2020 Accepting new patients
Caromont Medical Group Inc Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Dec 1, 2021 Accepting new patients
Caromont Medical Group, Inc. CurrentSince Nov 20, 2019 Accepting new patients
The Presbyterian Hospital CurrentSince Dec 1, 2020 Accepting new patients
Caromont Medical Group Inc CurrentSince Nov 20, 2019 Accepting new patients
Novant Medical Group, Inc. Past Accepting new patients

Locations

125 Queens Rd
Ste 400
Charlotte, NC 28204
Phone (980) 302-6400

125 Queens Rd
Ste 420
Charlotte, NC 28204
Phone (980) 302-6450

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

8201 Healthcare Loop
Ste 201
Charlotte, NC 28215
Phone (704) 316-3024

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

2711 X Ray Dr
Ste 3701
Gastonia, NC 28054
Phone (980) 384-9600

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: khepburn845464@direct.novanthealth.org

Organizations & group practices 10

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1437708310",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD STE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043215",
            "telephone_number": "980-302-6400",
            "fax_number": "980-302-6405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10905 Providence Rd W Ste 150",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282771538",
            "country_code": "US",
            "telephone_number": "980-302-7120",
            "fax_number": "980-302-7125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEPBURN",
        "first_name": "KRYSTIN",
        "middle_name": "BROOKE",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5012249",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "258915",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "258915",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437708310",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "khepburn845464@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "125 Queens Rd Ste 400",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.