Individual provider Active NPI

Kevin Burroughs, MD

  • Family Medicine Physician
  • Concord, NC
National Provider Identifier
1750378576
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9901134 Issued in NC
Practice address
270 Copperfield Blvd NE
Ste 102
Concord, NC 28025-2441
Phone
(704) 786-6521
NPI assigned
Oct 6, 2005
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 9901134 NC
Family Medicine Physician 207Q00000X 9901134 NC Primary

Addresses

Primary practice location

270 Copperfield Blvd NE
Ste 102
Concord, NC 28025-2441

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

5735 Prosperity Crossing Dr
Ste 2100
Charlotte, NC 28269-1360
Phone (704) 863-4878

Other practice location 2

2090 S US 29 Hwy
China Grove, NC 28023-8650
Phone (704) 403-6800

Other practice location 3

5651 Poplar Tent Rd
Ste 102
Concord, NC 28027-7686
Phone (704) 863-4878

Other practice location 4

14214 Ballantyne Lake Rd
Ste 150
Charlotte, NC 28277-3372
Phone (704) 863-4878

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kburroughs128634@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070912000309 NC Practitioner - Sports MedicinePractitioner - General PracticePractitioner - Family Practice 5597858118 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
University of North Carolina at Chapel Hill School of Medicine, 1996
Medicare assignment
May accept Medicare assignment
Group practices
Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 clinicians
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians
Carolinas Physicians Network IncGroup PAC ID 3375449655, shared by 56 NPIs, 2,324 clinicians

Practice addresses (Care Compare)

236 Lephillip Court
Suite a
Concord, NC 28025-1917
Phone (419) 221-6717

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

5651 Poplar Tent Rd
Suite 102
Concord, NC 28027-7686
Phone (704) 782-4878

6604 Roberta Rd
Harrisburg, NC 28075-9532
Phone (419) 221-6717

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9901134NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Sports Medicine CurrentSince Sep 1, 2007 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Mar 17, 2021 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Sep 1, 2007 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Cabarrus Family Medicine Past Accepting new patients

Locations

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

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

14214 Ballantyne Lake Rd
Ste 150
Charlotte, NC 28277
Phone (704) 373-1813

5735 Prosperity Crossing Dr
Ste 2100
Charlotte, NC 28269

2090 S US 29 Hwy
China Grove, NC 28023
Phone (704) 403-6800

270 Copperfield Blvd NE
Ste 102
Concord, NC 28025
Phone (704) 721-2060

5651 Poplar Tent Rd
Ste 102
Concord, NC 28027
Phone (704) 782-4878

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/c32cb33f-ec61-4f25-9140-0b9b174fe4db/
  • Direct secure messaging: kburroughs128634@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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 9

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1750378576",
    "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": "270 COPPERFIELD BLVD NE",
            "address_2": "STE 102",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252441",
            "telephone_number": "704-786-6521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5735 Prosperity Crossing Dr",
            "address_2": "STE 2100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282691360",
            "country_code": "US",
            "telephone_number": "704-863-4878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2090 S US 29 Hwy",
            "address_purpose": "LOCATION",
            "city": "China Grove",
            "state": "NC",
            "postal_code": "280238650",
            "country_code": "US",
            "telephone_number": "704-403-6800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5651 Poplar Tent Rd",
            "address_2": "Ste 102",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280277686",
            "country_code": "US",
            "telephone_number": "704-863-4878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14214 Ballantyne Lake Rd",
            "address_2": "Ste 150",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773372",
            "country_code": "US",
            "telephone_number": "704-863-4878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURROUGHS",
        "first_name": "KEVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2024-07-15",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NC",
            "license": "9901134",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9901134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kburroughs128634@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "270 Copperfield Blvd NE",
            "address_2": "Ste 102",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252441",
            "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 Concord, NC

Sources for this page

Verify at the official NPI Registry.