NPIMap

Organization Active NPI

Carolina Kidney Associates PA

  • Nephrology Physician
  • Greensboro, NC
National Provider Identifier
1700831799
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
CAROLINA KIDNEY ASSOCIATES PA
Practice address
309 New St
Greensboro, NC 27405-3654
Phone
(336) 379-9708
Fax
(336) 379-8714
NPI assigned
May 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Authorized official

Name
Mrs. Danielle Bynum
Title
Revenue Cycle Manager
Phone
(336) 379-9708

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

309 New St
Greensboro, NC 27405-3654

Mailing address

309 New St
Greensboro, NC 27405-3654
Phone (336) 379-9708

Other identifiers 3

IdentifierTypeStateIssuer
01598OtherNCCKA'S BCBS GP PROV #
CD6638OtherNCCKA'S RRM GP PROV #
8901598MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040119000489 NC Part B Supplier - Clinic/Group Practice 8628979952 Receives reassigned benefits from 23 practitioners
1 other NPI on this enrollment
Practice locations: Greensboro, NC

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2328143Carolina Kidney Associates309 New St, Greensboro, NC 27405Certificate of waiverAug 4, 2027

National Provider Directory

National Provider Directory

Locations

187 Browers Chapel Rd
Asheboro, NC 27205
Phone (336) 318-0380

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1700831799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 NEW ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274053654",
            "telephone_number": "336-379-9708",
            "fax_number": "336-379-8714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 NEW ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274053654",
            "telephone_number": "336-379-9708",
            "fax_number": "336-379-8714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA KIDNEY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "BYNUM",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "336-379-9708",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CKA'S BCBS GP PROV #",
            "identifier": "01598",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CKA'S RRM GP PROV #",
            "identifier": "CD6638",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901598",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.