Individual provider Active NPI

Amber Dean Kagen, PA-C

  • Physician Assistant
  • Belmont, NC
National Provider Identifier
1487193322
Registry record updated Oct 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-07144 Issued in NC
Practice address
1220 Spruce St
Belmont, NC 28012
Phone
(704) 825-5333
Fax
(704) 825-1751
NPI assigned
Feb 13, 2017
Last updated
Oct 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-07144 NC Primary

Addresses

Primary practice location

1220 Spruce St
Belmont, NC 28012

Mailing address

1220 Spruce St
Belmont, NC 28012-3370
Phone (704) 834-2450

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
I20170607002579 NC Practitioner - Physician Assistant 1951679372 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

1220 Spruce St
Belmont, NC 28012-3370
Phone (704) 825-5333

660 Summit Crossing PL
Suite 301
Gastonia, NC 28054-2181
Phone (704) 854-8799

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-07144NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gastonia Physician Services, PLLC CurrentSince Mar 1, 2017 Accepting new patients
Gastonia Physician Services, PLLC CurrentSince Mar 1, 2017 Accepting new patients
Caromont Medical Group, Inc. CurrentSince Dec 1, 2019 Accepting new patients
Caromont Medical Group Inc CurrentSince Dec 1, 2019 Accepting new patients

Locations

1220 Spruce St
Belmont, NC 28012
Phone (704) 263-0300

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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 2

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": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633824000000",
    "number": "1487193322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 SPRUCE ST",
            "city": "BELMONT",
            "state": "NC",
            "postal_code": "280123370",
            "telephone_number": "704-834-2450",
            "fax_number": "704-825-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 SPRUCE ST",
            "city": "BELMONT",
            "state": "NC",
            "postal_code": "28012",
            "telephone_number": "704-825-5333",
            "fax_number": "704-825-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAGEN",
        "first_name": "AMBER",
        "middle_name": "DEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2021-10-10",
        "certification_date": "2021-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, NC

Sources for this page

Verify at the official NPI Registry.