Kimberly Elysia Spatola, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

L004277 Issued in NC

Practice address

125 Queens Rd Ste 330
Charlotte, NC 28204-3419

Phone

(704) 384-5043

Fax

(704) 384-8895

NPI assigned

Nov 12, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kspatola332909@direct.novanthealth.org

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.

• Novant Health Medical Group, LLC

  dba NHMG Primary Care Clinics

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD (past)

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

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1447689468",
    "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": "704-384-5043",
            "fax_number": "704-384-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD STE 330",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043419",
            "telephone_number": "704-384-5043",
            "fax_number": "704-384-8895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPATOLA",
        "first_name": "KIMBERLY",
        "middle_name": "ELYSIA",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-12",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L004277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kspatola332909@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "125 Baldwin Ave Ste 200",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Penny Sparks, FNP
• Matthew Sparling, M.S.ED
• Kaylea Nicole Sparrow, LCMHCA
• Keri Kemp Sparrow, BCBA
• Joseph David Spataro, MD
• Meredith Spatola
• Christie H Spaugh, MPT
• Eumika Q Spaulding-Tillman, PHARMD
• Blaire Spaulding, DMD
• Courtney Godwin Spaulding, M.S.

• Registered Dietitian in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.