Active NPI
Karen D Donald, PA-C
- Physician Assistant
- Charlotte, NC
National Provider Identifier
1750304069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 100549
- Practice address
- 1001 Blythe Blvd
Suite 500
Charlotte, NC 28203-5863 - Phone
- (704) 355-5100
- Fax
- (704) 355-5180
- NPI assigned
- Jul 26, 2006
- Last updated
- Jan 9, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1434 | SC | |
| Physician Assistant | 363A00000X | 100549 | NC | Primary |
| Internal Medicine Physician | 207R00000X | 100549 | NC |
Addresses
Primary practice location
1001 Blythe Blvd
Suite 500
Charlotte, NC 28203-5863
Mailing address
PO Box 601643
Charlotte, NC 28260-1643
Phone (704) 355-5100
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0884PA | Medicaid | SC | |
| 1750304069 | Medicaid | NC | |
| 8101103 | Medicaid | NC |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100549 | NC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483920000000",
"number": "1750304069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 601643",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282601643",
"telephone_number": "704-355-5100",
"fax_number": "704-355-5180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 BLYTHE BLVD",
"address_2": "SUITE 500",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035863",
"telephone_number": "704-355-5100",
"fax_number": "704-355-5180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONALD",
"first_name": "KAREN",
"middle_name": "D",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2017-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "SC",
"license": "1434",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "100549",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NC",
"license": "100549",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0884PA",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1750304069",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8101103",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
- Maya Domoto, LPC
- Don G. Timpton, D.D.S. & Associates, PA (Carmel Commons Dental)
- Donaco Medical Supply, LLC (HR HealthCare Patient Services)
- Alexandra Beery Donahue, PA-C
- Donald D. Fraser, M.D., P.a.
- Morgan Donald
- Cynthia J Donatelli, CRNA
- Lindsey Yvette Donatien, LCMHC
- Roberto A Doncel Reyna
- Ha Uyen This Dong
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.