Individual provider Active NPI

Kimberly Stover, M.D.

  • Emergency Medicine Physician
  • Concord, NC
National Provider Identifier
1740544345
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2015-01112 Issued in NC
Practice address
1028 Lee Ann Dr NE Ste 200
Concord, NC 28025-2915
Phone
(704) 782-1892
Fax
(704) 786-1890
NPI assigned
Jun 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 125-061734 IL
Emergency Medicine Physician 207P00000X 2015-01112 NC Primary

Addresses

Primary practice location

1028 Lee Ann Dr NE Ste 200
Concord, NC 28025-2915

Mailing address

1028 Lee Ann Dr NE Ste 200
Concord, NC 28025-2915
Phone (704) 782-1892

Other names 1

  • Kimberly Beam Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151021002408 NC Practitioner - Emergency Medicine 9335458900 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest Emergency ProvidersGroup PAC ID 7012819816, 497 clinicians

Practice addresses (Care Compare)

920 Church St N
Concord, NC 28025-2927
Phone (704) 403-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125-061734ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians of Mecklenburg County, PLLC Emergency Medicine CurrentSince Apr 29, 2016 Accepting new patients
Wake Forest Emergency Providers CurrentSince Aug 9, 2022 Accepting new patients

Locations

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

6965 Fairview Rd
Charlotte, NC 28210
Phone (704) 631-1300

10628 Park Rd
Charlotte, NC 28210
Phone (704) 543-2000

2001 Vail Ave
Charlotte, NC 28207
Phone (704) 304-5000

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

2711 Lane St
Kannapolis, NC 28083
Phone (704) 403-1275

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.

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": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1740544345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 LEE ANN DR NE STE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252915",
            "telephone_number": "704-782-1892",
            "fax_number": "704-786-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 LEE ANN DR NE STE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252915",
            "telephone_number": "704-782-1892",
            "fax_number": "704-786-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVER",
        "first_name": "KIMBERLY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125-061734",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2015-01112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "BEAM",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.