Individual provider Active NPI

Kera Cosper Mondez, DNP, FNP-C

  • Family Nurse Practitioner
  • Statesville, NC
National Provider Identifier
1699181651
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5006985 Issued in NC
Practice address
633 Brookdale Dr Ste 100
Statesville, NC 28677-3471
Phone
(704) 873-7850
NPI assigned
Jul 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2019

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 5006985 NC Primary

Addresses

Primary practice location

633 Brookdale Dr Ste 100
Statesville, NC 28677-3471

Mailing address

138 Sherlock Dr
Statesville, NC 28625-1916
Phone (704) 873-1021

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
I20141030001329 NC Practitioner - Nurse Practitioner 0547481822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Medical University of South Carolina College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Healthcare PAGroup PAC ID 9638070683, 226 clinicians

Practice addresses (Care Compare)

138 Sherlock Dr
Statesville, NC 28625-1916
Phone (704) 873-1021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5006985NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Healthcare, P.a. CurrentSince Aug 11, 2014 Accepting new patients
Piedmont Healthcare, PA CurrentSince Aug 11, 2014 Accepting new patients

Locations

138 Sherlock Dr
Statesville, NC 28625
Phone (704) 872-1021

208 Old Mocksville Rd
Statesville, NC 28625
Phone (704) 838-8215

633 Brookdale Dr
Ste 100
Statesville, NC 28677
Phone (704) 873-7850

650 Signal Hill Drive Ext
Statesville, NC 28625
Phone (704) 873-4277

Organizations & group practices 2

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": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1699181651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 SHERLOCK DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286251916",
            "telephone_number": "704-873-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 BROOKDALE DR STE 100",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773471",
            "telephone_number": "704-873-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDEZ",
        "first_name": "KERA",
        "middle_name": "COSPER",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-10",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5006985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.