Individual provider Active NPI

Coral D Kirscher, FNP-C

  • Family Nurse Practitioner
  • Cornelius, NC
National Provider Identifier
1659819001
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5009264 Issued in NC
Practice address
18805 W Catawba Ave Ste 100
Cornelius, NC 28031-4608
Phone
(704) 612-0011
Fax
(704) 612-0012
NPI assigned
Feb 6, 2017
Last updated
May 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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 5009264 NC Primary

Addresses

Primary practice location

18805 W Catawba Ave Ste 100
Cornelius, NC 28031-4608

Mailing address

18805 W Catawba Ave Ste 100
Cornelius, NC 28031-4608
Phone (704) 612-0011

Other names 1

  • Coral D Bruss Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 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
I20170320001870 NC Practitioner - Nurse Practitioner 9032494711 Reassigns benefits to 2 organizations
I20251010001314 SC Practitioner - Nurse Practitioner 9032494711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renew Wound Care SpecialistsGroup PAC ID 1153711940, 7 clinicians
Renew Wound Care Center PLLCGroup PAC ID 6901326248, 5 clinicians

Practice addresses (Care Compare)

18805 W Catawba Ave
Suite 205a
Cornelius, NC 28031-4609
Phone (704) 612-0011

436 Hadley St
Mount Airy, NC 27030-4517
Phone (704) 612-0011

6650 Rivers Ave
Suite 100
North Charleston, SC 29406-4809
Phone (704) 612-0011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5009264NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Wound Care Specialists CurrentSince Sep 7, 2021 Accepting new patients
Renew Speciality Group Current Accepting new patients
Renew Wound Care Center PLLC CurrentSince Dec 18, 2024 Accepting new patients

Locations

18805 W Catawba Ave
Ste 100
Cornelius, NC 28031
Phone (704) 612-0011

18805 W Catawba Ave
Ste 205A
Cornelius, NC 28031
Phone (704) 310-1043

6650 Rivers Ave
Ste 100
North Charleston, SC 29406
Phone (407) 469-5088

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1659819001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18805 W CATAWBA AVE STE 100",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314608",
            "telephone_number": "704-612-0011",
            "fax_number": "704-612-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18805 W CATAWBA AVE STE 100",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314608",
            "telephone_number": "704-612-0011",
            "fax_number": "704-612-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSCHER",
        "first_name": "CORAL",
        "middle_name": "D",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-06",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5009264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORAL",
            "last_name": "BRUSS",
            "middle_name": "D",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cornelius, NC

Sources for this page

Verify at the official NPI Registry.