Individual provider Active NPI

Kimberly Sue Vazquez

  • Student in an Organized Health Care Education/Training Program
  • Charlotte, NC
National Provider Identifier
1689509671
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
5024447 Issued in NC
Practice address
6331 Carmel Rd Ste 102
Charlotte, NC 28226-8286
Phone
(704) 316-2354
NPI assigned
Jun 12, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 5024447 NC Primary

Addresses

Primary practice location

6331 Carmel Rd Ste 102
Charlotte, NC 28226-8286

Mailing address

1315 East Blvd Ste 280
Charlotte, NC 28203-5793
Phone (704) 384-1866

Other practice location 1

1315 East Blvd Ste 280
Charlotte, NC 28203-5793
Phone (704) 384-1866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1781222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1689509671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 EAST BLVD STE 280",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035793",
            "telephone_number": "704-384-1866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6331 CARMEL RD STE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282268286",
            "telephone_number": "704-316-2354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1315 East Blvd Ste 280",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035793",
            "country_code": "US",
            "telephone_number": "704-384-1866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-12",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "5024447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.