Individual provider Active NPI

Kimberly Paige Lemaster, M.D.

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1447223870
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
9600605 Issued in NC
Practice address
11840 Southmore Dr
Suite 100
Charlotte, NC 28277-4466
Phone
(704) 384-1166
Fax
(704) 384-1181
NPI assigned
Feb 8, 2006
Last updated
Nov 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 9600605 NC Primary

Addresses

Primary practice location

11840 Southmore Dr
Suite 100
Charlotte, NC 28277-4466

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other identifiers 1

IdentifierTypeStateIssuer
891039HMedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address klemaster15557@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130523000717 NC Practitioner - Pediatric Medicine 6800034299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

11840 Southmore Dr
Charlotte, NC 28277-4466
Phone (704) 384-1166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9600605NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 13, 2013 Accepting new patients
Novant Medical Group Inc CurrentSince Feb 13, 2013 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

11840 Southmore Dr
Charlotte, NC 28277
Phone (704) 316-4443

11840 Southmore Dr
Ste 100
Charlotte, NC 28277
Phone (704) 316-4440

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1447223870",
    "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": "11840 SOUTHMORE DR",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774466",
            "telephone_number": "704-384-1166",
            "fax_number": "704-384-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMASTER",
        "first_name": "KIMBERLY",
        "middle_name": "PAIGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9600605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891039H",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klemaster15557@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "11840 Southmore Dr",
            "address_2": "Suite 100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282774466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.