Individual provider Active NPI

Keller Dunaway Earnst, FNP

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1447512074
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5007246 Issued in NC
Practice address
1901 Randolph Rd
Charlotte, NC 28207-1101
Phone
(704) 384-5429
NPI assigned
Jun 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 17700 SC
Nurse Practitioner 363L00000X 5007246 NC Primary

Addresses

Primary practice location

1901 Randolph Rd
Charlotte, NC 28207-1101

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 749-5800

Other practice location 1

200 Providence Rd Ste 101
Charlotte, NC 28207-1437
Phone (704) 749-5800

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
I20150115001737 NC Practitioner - Nurse Practitioner 5294963930 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
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)

330 Billingsley Rd
Suite 202
Charlotte, NC 28211-5020
Phone (704) 316-2350

Hospital & facility affiliations

  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
  • Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
  • Novant Health Mint Hill Medical Center Hospital, Charlotte, NC, CCN 340190
  • Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Nov 30, 2024 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Nov 30, 2024 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Providence Anesthesiology Associates, P.a. CurrentSince Nov 1, 2014 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

200 Providence Rd
Ste 101
Charlotte, NC 28207

330 Billingsley Rd
Ste 202
Charlotte, NC 28211
Phone (704) 316-2350

131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101

1901 Randolph Rd
Charlotte, NC 28207
Phone (704) 316-2000

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

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

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

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

Interoperability endpoints

  • Direct secure messaging: kearnst194413@direct.novanthealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1447512074",
    "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",
            "telephone_number": "704-749-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 RANDOLPH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071101",
            "telephone_number": "704-384-5429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Providence Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282071437",
            "country_code": "US",
            "telephone_number": "704-749-5800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EARNST",
        "first_name": "KELLER",
        "middle_name": "DUNAWAY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "17700",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5007246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.