NPIMap

Individual provider Active NPI

Kelly Reyna Radford, DO

  • Family Medicine Physician
  • Kings Mountain, NC
National Provider Identifier
1750763876
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2018-00301 Issued in NC
Practice address
2202 Carolina PL
Ste 100
Kings Mountain, NC 28086-8807
Phone
(980) 487-2290
NPI assigned
Jun 25, 2015
Sex
Female
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2018-00301 NC Primary

Addresses

Primary practice location

2202 Carolina PL
Ste 100
Kings Mountain, NC 28086-8807

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kradford1062344@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 SC, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180214002213 SC Practitioner - Family Practice 1052699337 Reassigns benefits to 2 organizations
I20180622002313 NC Practitioner - Family Practice 1052699337 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

2202 Carolina PL
Suite 100
Kings Mountain, NC 28086-8807
Phone (980) 487-2270

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Atrium Health Cleveland Hospital, Shelby, NC, CCN 340021
  • Caromont Regional Medical Center Hospital, Gastonia, NC, CCN 340032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018-00301NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anmed Health Current Accepting new patients
Anmed Health Family Medicine CurrentSince Jan 1, 2018 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 3, 2022 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Anmed Health Family Medicine CurrentSince Jan 1, 2018 Accepting new patients
DLP Rutherford Physician Practices LLC CurrentSince Aug 1, 2018 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 3, 2022 Accepting new patients
Anmed Health Family Medicine Current Accepting new patients
DLP Rutherford Physician Practices LLC Family Medicine CurrentSince Aug 1, 2018 Accepting new patients
Anmed Health Family Medicine CurrentSince Jan 1, 2018 Accepting new patients
Carolinas Physicians Network, Inc Family Medicine Past Accepting new patients
DLP Rutherford Physician Practices LLC 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

801 W Mills St
Ste B
Columbus, NC 28722
Phone (828) 692-8097

1269 US Highway 221A
Forest City, NC 28043
Phone (828) 657-5371

112 Sparks Dr
Forest City, NC 28043
Phone (704) 675-7279

212 Allendale Dr
Forest City, NC 28043
Phone (828) 245-3575

2202 Carolina Pl
#100
Kings Mountain, NC 28086
Phone (980) 487-2270

605 NC 120 Hwy
Mooresboro, NC 28114
Phone (828) 453-0703

288 S Ridgecrest Ave
Rutherfordton, NC 28139
Phone (252) 808-6000

600 N Fant St
Anderson, SC 29621
Phone (864) 512-1787

800 N Fant St
Anderson, SC 29621
Phone (864) 512-1000

885 Tiger Blvd
Clemson, SC 29631
Phone (864) 512-4530

895 Tiger Blvd
Clemson, SC 29631
Phone (864) 512-4530

Interoperability endpoints

  • Direct secure messaging: kradford1062344@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 12

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 8

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": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1750763876",
    "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": "2202 CAROLINA PL",
            "address_2": "STE 100",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280868807",
            "telephone_number": "980-487-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADFORD",
        "first_name": "KELLY",
        "middle_name": "REYNA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2024-07-15",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2018-00301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kradford1062344@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "2202 Carolina Pl",
            "address_2": "Ste 100",
            "city": "Kings Mountain",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280868807",
            "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 Kings Mountain, NC

Sources for this page

Verify at the official NPI Registry.