NPIMap

Individual provider Active NPI

Charis Elizabeth Klein, AGACNP

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1447907753
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5015891 Issued in NC
Practice address
1918 Randolph Rd Ste 400
Charlotte, NC 28207-1196
Phone
(704) 316-2350
Fax
(704) 316-2351
NPI assigned
Mar 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 5015891 NC
Nurse Practitioner 363L00000X 5015891 NC Primary

Addresses

Primary practice location

1918 Randolph Rd Ste 400
Charlotte, NC 28207-1196

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-2350

Other practice location 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220518001303 NC Practitioner - Nurse Practitioner 8820475585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5015891NCMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Medical Group Inc CurrentSince May 5, 2022 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 5, 2022 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

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

1918 Randolph Rd
Ste 400
Charlotte, NC 28207
Phone (704) 384-9437

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

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

190 Kimel Park Dr
Ste 131
Winston Salem, NC 27103
Phone (336) 718-5763

Interoperability endpoints

  • Direct secure messaging: cklein83706@direct.novanthealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1447907753",
    "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": "704-316-2350",
            "fax_number": "704-316-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 RANDOLPH RD STE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071196",
            "telephone_number": "704-316-2350",
            "fax_number": "704-316-2351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Billingsley Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282115020",
            "country_code": "US",
            "telephone_number": "704-316-2350",
            "fax_number": "704-316-2351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "CHARIS",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-07",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "5015891",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5015891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.