Individual provider Active NPI

Kylie Erin Buskirk, APRN

  • Pediatric Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1558073197
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5017356 Issued in NC
Practice address
5370 Ridge Rd
Charlotte, NC 28269-2298
Phone
(704) 316-1491
Fax
(704) 316-1492
NPI assigned
Dec 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5017356 NC
Pediatric Nurse Practitioner 363LP0200X 5017356 NC Primary

Addresses

Primary practice location

5370 Ridge Rd
Charlotte, NC 28269-2298

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

6331 Carmel Rd Ste 102
Charlotte, NC 28226-8286
Phone (386) 848-8746

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
I20230228003095 NC Practitioner - Nurse Practitioner 7315310059 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5017356NCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Feb 12, 2023 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group. LLC CurrentSince Feb 12, 2023 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

5370 Ridge Rd
Charlotte, NC 28269
Phone (704) 316-1491

6331 Carmel Rd
Ste 102
Charlotte, NC 28226
Phone (704) 316-2354

517 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 384-1406

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

Interoperability endpoints

  • Direct secure messaging: kbuskirk1019254@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.

NPI Registry JSON

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

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1558073197",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5370 RIDGE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282692298",
            "telephone_number": "704-316-1491",
            "fax_number": "704-316-1492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6331 Carmel Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282268286",
            "country_code": "US",
            "telephone_number": "386-848-8746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSKIRK",
        "first_name": "KYLIE",
        "middle_name": "ERIN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-14",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5017356",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5017356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.