Individual provider Active NPI

Kalei Reid Tacik, NP

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1487454732
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5021835 Issued in NC
Practice address
10000 Park Cedar Dr
Charlotte, NC 28210-8902
Phone
(704) 667-3600
NPI assigned
Mar 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5021835 NC Primary

Addresses

Primary practice location

10000 Park Cedar Dr
Charlotte, NC 28210-8902

Mailing address

10000 Park Cedar Dr
Charlotte, NC 28210-8902
Phone (704) 667-3600

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
I20250506003383 NC Practitioner - Nurse Practitioner 3476070186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

10000 Park Cedar Dr
Charlotte, NC 28210-8902
Phone (704) 667-3600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5021835NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Jun 15, 2025 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jun 15, 2025 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients

Locations

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

10000 Park Cedar Dr
Charlotte, NC 28210
Phone (704) 541-5355

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

Interoperability endpoints

  • Direct secure messaging: ktacik2894815@carolinashealthcaresystem.direct-ci.com

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": "1742169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1487454732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 PARK CEDAR DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108902",
            "telephone_number": "704-667-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 PARK CEDAR DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108902",
            "telephone_number": "704-667-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACIK",
        "first_name": "KALEI",
        "middle_name": "REID",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-17",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5021835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.