Individual provider Active NPI

Kyndal Leigh Funderburk, NP

  • Nurse Practitioner
  • Matthews, NC
National Provider Identifier
1447889704
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5015548 Issued in NC
Practice address
1100 Healing Way
Ste 13
Matthews, NC 28104-5159
Phone
(980) 993-1700
NPI assigned
Apr 7, 2020
Last updated
Jul 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5015548 NC Primary
Acute Care Nurse Practitioner 363LA2100X 5015548 NC
Adult Health Nurse Practitioner 363LA2200X 5015548 NC
Gerontology Nurse Practitioner 363LG0600X 5015548 NC

Addresses

Primary practice location

1100 Healing Way
Ste 13
Matthews, NC 28104-5159

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

100 Medical Park Dr
Ste 210
Concord, NC 28025-2948
Phone (704) 403-6100

Other practice location 2

1550 Faulk St
Ste 3100
Monroe, NC 28112-5086
Phone (704) 667-3410

Other practice location 3

1237 Harding Pl
Ste 3100
Charlotte, NC 28204
Phone (704) 373-0212

Other practice location 4

10650 Park Rd
Charlotte, NC 28210-8538
Phone (704) 667-3840

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kfunderburk125154@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20210209002078 SC Practitioner - Nurse Practitioner 0749695500 Reassigns benefits to 2 organizations
I20220131000293 NC Practitioner - Nurse Practitioner 0749695500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

100 Medical Park Dr
Suite 210
Concord, NC 28025-2966
Phone (704) 403-6100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5015548NCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Cardiology Associates LLC CurrentSince Oct 25, 2025 Accepting new patients
SC Hospital Medicine Physicians LLC CurrentSince Nov 1, 2021 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 31, 2022 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 31, 2022 Accepting new patients
Carolina Heart Specialists LLC CurrentSince Nov 4, 2020 Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

10650 Park Rd
Charlotte, NC 28210
Phone (704) 667-0337

1237 Harding Pl
Ste 3100
Charlotte, NC 28204

100 Medical Park Dr
Ste 210
Concord, NC 28025
Phone (704) 403-6100

990 Lee Ann Dr NE
Concord, NC 28025
Phone (704) 441-0272

1100 Healing Way
Ste 13
Matthews, NC 28104
Phone (980) 993-1700

1550 Faulk St
Ste 3100
Monroe, NC 28112
Phone (704) 667-3410

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

1029 W Meeting St
Lancaster, SC 29720
Phone (803) 285-2041

800 W Meeting St
Lancaster, SC 29720
Phone (803) 286-1214

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kfunderburk125154@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 6

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 9

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": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1447889704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 HEALING WAY",
            "address_2": "STE 13",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281045159",
            "telephone_number": "980-993-1700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Medical Park Dr",
            "address_2": "Ste 210",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252948",
            "country_code": "US",
            "telephone_number": "704-403-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1550 Faulk St",
            "address_2": "Ste 3100",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "NC",
            "postal_code": "281125086",
            "country_code": "US",
            "telephone_number": "704-667-3410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1237 Harding Pl",
            "address_2": "Ste 3100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28204",
            "country_code": "US",
            "telephone_number": "704-373-0212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10650 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108538",
            "country_code": "US",
            "telephone_number": "704-667-3840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUNDERBURK",
        "first_name": "KYNDAL",
        "middle_name": "LEIGH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-07",
        "last_updated": "2024-07-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5015548",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "5015548",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5015548",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "5015548",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kfunderburk125154@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1100 Healing Way",
            "address_2": "Ste 13",
            "city": "Matthews",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281045159",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.