Individual provider Active NPI

Kelsey Cruse Sommermann, PA

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1720671118
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-10590 Issued in NC
Practice address
10660 Park Rd
Ste 2100
Charlotte, NC 28210-8413
Phone
(980) 442-0410
NPI assigned
Feb 16, 2021
Last updated
Apr 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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 0010-10590 NC Primary

Addresses

Primary practice location

10660 Park Rd
Ste 2100
Charlotte, NC 28210-8413

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

4525 Cameron Valley Pkwy
Ste 3500
Charlotte, NC 28211-4369
Phone (704) 302-8300

Other practice location 2

1021 Morehead Medical Dr
Ste A
Charlotte, NC 28204-2990
Phone (980) 442-2000

Other practice location 3

100 Medical Park Dr
Ste 110
Concord, NC 28025-2948
Phone (704) 403-1370

Other practice location 4

945 N 5th St
Albemarle, NC 28001-3417
Phone (980) 323-7790

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kcruse426505@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

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
I20210423002182 NC Practitioner - Physician Assistant 2062820467 Reassigns benefits to 1 organization

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)

10628 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-1000

10660 Park Rd
Suite 1100
Charlotte, NC 28210-8407
Phone (980) 442-5400

275 Hwy 16 N
Suite 202
Denver, NC 28037-3002
Phone (704) 732-9843

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-10590NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince May 3, 2021 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince May 3, 2021 Accepting new patients
Carolinas Medical Center-Northeast Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

945 N 5th St
Albemarle, NC 28001
Phone (980) 323-7790

1021 Morehead Medical Dr
Ste A
Charlotte, NC 28204
Phone (704) 355-2884

10660 Park Rd
Ste 2100
Charlotte, NC 28210
Phone (980) 442-0410

4525 Cameron Valley Pkwy
Ste 3500
Charlotte, NC 28211
Phone (704) 302-8300

100 Medical Park Dr
Ste 110
Concord, NC 28025
Phone (704) 403-1370

Interoperability endpoints

  • Direct secure messaging: kcruse426505@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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": "1613433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1720671118",
    "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": "10660 PARK RD",
            "address_2": "STE 2100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108413",
            "telephone_number": "980-442-0410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4525 Cameron Valley Pkwy",
            "address_2": "Ste 3500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282114369",
            "country_code": "US",
            "telephone_number": "704-302-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1021 Morehead Medical Dr",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042990",
            "country_code": "US",
            "telephone_number": "980-442-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Medical Park Dr",
            "address_2": "Ste 110",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252948",
            "country_code": "US",
            "telephone_number": "704-403-1370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "945 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Albemarle",
            "state": "NC",
            "postal_code": "280013417",
            "country_code": "US",
            "telephone_number": "980-323-7790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOMMERMANN",
        "first_name": "KELSEY",
        "middle_name": "CRUSE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-16",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-10590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcruse426505@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "10660 Park Rd",
            "address_2": "Ste 2100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282108413",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.