Individual provider Active NPI

Micah Kirscher

  • Nurse Practitioner
  • Cornelius, NC
National Provider Identifier
1821546326
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11111111 Issued in NC
Practice address
18805 W Catawba Ave Ste 100
Cornelius, NC 28031-4608
Phone
(704) 612-0011
Fax
(704) 612-0012
NPI assigned
Sep 14, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11111111 NC Primary

Addresses

Primary practice location

18805 W Catawba Ave Ste 100
Cornelius, NC 28031-4608

Mailing address

18805 W Catawba Ave Ste 100
Cornelius, NC 28031-4608
Phone (704) 612-0011

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
I20161206000470 NC Practitioner - Nurse Practitioner 4880974005 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renew Wound Care SpecialistsGroup PAC ID 1153711940, 7 clinicians
Renew Wound Care Center PLLCGroup PAC ID 6901326248, 5 clinicians

Practice addresses (Care Compare)

18805 W Catawba Ave
Suite 205a
Cornelius, NC 28031-4609
Phone (704) 612-0011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11111111NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Wound Care Specialists Nurse Practitioner CurrentSince Sep 7, 2021 Accepting new patients
Renew Wound Care Center PLLC CurrentSince Dec 18, 2024 Accepting new patients
Renew Health and Wellness Past Accepting new patients

Locations

18805 W Catawba Ave
Ste 205A
Cornelius, NC 28031
Phone (704) 310-1043

18805 W Catawba Ave
Ste 100
Cornelius, NC 28031
Phone (704) 612-0011

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1821546326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18805 W CATAWBA AVE STE 100",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314608",
            "telephone_number": "704-612-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18805 W CATAWBA AVE STE 100",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314608",
            "telephone_number": "704-612-0011",
            "fax_number": "704-612-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSCHER",
        "first_name": "MICAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-14",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "11111111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

Verify at the official NPI Registry.