NPIMap

Individual provider Active NPI

Jade Kimble, PA

  • Physician Assistant
  • Mount Pleasant, NC
National Provider Identifier
1689281958
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-10686 Issued in NC
Practice address
8560 Cook St
Mount Pleasant, NC 28124-7686
Phone
(704) 436-6521
NPI assigned
Sep 30, 2020
Last updated
Sep 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 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 0010-10686 NC Primary

Addresses

Primary practice location

8560 Cook St
Mount Pleasant, NC 28124-7686

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Ambulatory@direct.carolinashealthcare.org Atrium Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201103000779 NC Practitioner - Physician Assistant 1759791759 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1070 Vinehaven Dr NE
Concord, NC 28025-2438
Phone (704) 783-1840

510 Corporate Cir
Suite 1000
Salisbury, NC 28147-8074
Phone (704) 783-1840

9965 Poplar Tent Rd
Concord, NC 28027-9304
Phone (704) 783-1833

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cabarrus Gastroenterology Associates, PLLC CurrentSince Oct 1, 2021 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Sep 28, 2020 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Sep 28, 2020 Accepting new patients
Cabarrus Gastroenterology Associates, PLLC CurrentSince Oct 1, 2021 Accepting new patients
Cabarrus Gastroenterology Associates, PLLC Past Accepting new patients

Locations

1070 Vinehaven Dr NE
Concord, NC 28025
Phone (704) 783-1840

270 Copperfield Blvd NE
Ste 102
Concord, NC 28025
Phone (704) 403-3543

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

9965 Poplar Tent Rd
Concord, NC 28027
Phone (704) 783-1840

8560 Cook St
Mt Pleasant, NC 28124
Phone (704) 403-1911

510 Corporate Cir
#1000
Salisbury, NC 28147
Phone (704) 783-1840

Interoperability endpoints

  • Direct secure messaging: ambulatory@direct.carolinashealthcare.org
  • Direct secure messaging: jweeks405727@carolinashealthcaresystem.direct-ci.com

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": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1689281958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8560 COOK ST",
            "city": "MOUNT PLEASANT",
            "state": "NC",
            "postal_code": "281247686",
            "telephone_number": "704-436-6521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBLE",
        "first_name": "JADE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-30",
        "last_updated": "2021-09-20",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-10686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ambulatory@direct.carolinashealthcare.org",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "8560 Cook St",
            "city": "Mount Pleasant",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281247686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Pleasant, NC

Sources for this page

Verify at the official NPI Registry.