Kelly Walton Tanner, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5020562 Issued in NC

Practice address

111 E 3Rd Ave
Gastonia, NC 28052-4317

Phone

(704) 874-3300

Fax

(704) 874-0065

NPI assigned

Jul 31, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

NH-CL Clinics LLCGroup PAC ID 6305262692, 82 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• NH-CL Clinics, LLC

  dba CoreLife Novant Health

  • Family Medicine Physician
  • Kernersville, NC
  • NPI 1487276499
  Medicare reassignment Care Compare group NPD
• Gaston Family Health Services, Inc.

  dba Kintegra Family Medicine - Hudson

  • Federally Qualified Health Center (FQHC)
  • Gastonia, NC
  • NPI 1215932215
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  NC, Nurse Practitioner

  Medicare reassignment NPD
• Gaston Family Health Services, Inc

  dba Kintegra Family Medicine - Xray Dr

  • Federally Qualified Health Center (FQHC)
  • Gastonia, NC
  • NPI 1306644315
  NPD
• Neurosurgical Associates of the

  • Neurological Surgery Physician
  • Winston Salem, NC
  • NPI 1003917725
  NPD (past)

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1679302327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604050",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282604050",
            "telephone_number": "980-330-6808",
            "fax_number": "980-330-6938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 3RD AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524317",
            "telephone_number": "704-874-3300",
            "fax_number": "704-874-0065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 N Main St",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281444303",
            "country_code": "US",
            "telephone_number": "980-330-8048",
            "fax_number": "980-330-6938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANNER",
        "first_name": "KELLY",
        "middle_name": "WALTON",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-31",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5020562",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5020562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Raymond Tamberella III, M.D.
• Anh Nguyen Viet Tang, PHARMD
• Jenny Tang, MS, CCC-SLP
• Miracle Tann, LCSW-A
• Austin C Tanner, BT
• Velma Villalon Taormina, M.D.
• Eloisa Dela Cruz Taruc, PT, DPT
• Taulman Chiropractic Corporation (Gaston Upper Cervical Chiropractic)
• J. Christopher Taulman, D.C.
• April Gaetana Taylor

• Family Nurse Practitioner in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.