NPIMap

Individual provider Active NPI

Kelsey Alden Newberry, PA

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1871018275
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-10786 Issued in NC
Practice address
10650 Park Rd
Charlotte, NC 28210-8538
Phone
(704) 667-3840
NPI assigned
Aug 7, 2017
Last updated
Jul 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-10786 NC Primary

Addresses

Primary practice location

10650 Park Rd
Charlotte, NC 28210-8538

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-1255

Other practice location 2

1237 Harding Pl
Ste 3100
Charlotte, NC 28204
Phone (704) 373-0212

Other practice location 3

100 Medical Park Dr
Ste 210
Concord, NC 28025-2948
Phone (704) 403-6100

Other practice location 4

1237 Harding Pl
Ste 3300
Charlotte, NC 28204
Phone (704) 446-5860

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address knewberry460598@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 GA, NC, SC3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20180213002021 GA Practitioner - Physician Assistant 1254691264 Reassigns benefits to 1 organization
I20201230002147 NC Practitioner - Physician Assistant 1254691264 Reassigns benefits to 3 organizations
I20240828004977 SC Practitioner - Physician Assistant 1254691264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
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)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000

10628 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-1000

10648 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-7070

10650 Park Rd
Charlotte, NC 28210-8538
Phone (704) 667-3840

10650 Park Rd
Suite 300
Charlotte, NC 28210-8543
Phone (704) 667-3960

134 Medical Park Rd
Suite 111
Mooresville, NC 28117-8527
Phone (704) 801-9100

1656 Riverchase Blvd
Suite 2500
Rock Hill, SC 29732-0269
Phone (803) 327-3456

704 Gold Hill Rd
Suite 203
Fort Mill, SC 29715-8907
Phone (803) 835-0405

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
008375GAMDGeneral Practice Dentistry
0010-10786NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jan 25, 2021 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 25, 2021 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 25, 2021 Accepting new patients
Carolinas Medical Center CurrentSince Jan 25, 2021 Accepting new patients
Carolinas Physicians Network Inc CurrentSince May 16, 2024 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jan 25, 2021 Accepting new patients
Carolinas Medical Center CurrentSince Jan 25, 2021 Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients

Locations

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

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

10650 Park Rd
Charlotte, NC 28210
Phone (704) 667-0337

10660 Park Rd
Ste 3400
Charlotte, NC 28210
Phone (704) 667-1540

1237 Harding Pl
Ste 3100
Charlotte, NC 28204

1237 Harding Pl
Ste 3300
Charlotte, NC 28204
Phone (704) 446-5860

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

100 Medical Park Dr
Ste 210
Concord, NC 28025
Phone (704) 403-6100

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

990 Lee Ann Dr NE
Concord, NC 28025
Phone (704) 441-0272

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

704 Gold Hill Rd
Ste 203
Fort Mill, SC 29715
Phone (803) 835-0405

Interoperability endpoints

  • Direct secure messaging: knewberry460598@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1871018275",
    "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": "10650 PARK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108538",
            "telephone_number": "704-667-3840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-1255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1237 Harding Pl",
            "address_2": "Ste 3100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28204",
            "country_code": "US",
            "telephone_number": "704-373-0212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Medical Park Dr",
            "address_2": "Ste 210",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252948",
            "country_code": "US",
            "telephone_number": "704-403-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1237 Harding Pl",
            "address_2": "Ste 3300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28204",
            "country_code": "US",
            "telephone_number": "704-446-5860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEWBERRY",
        "first_name": "KELSEY",
        "middle_name": "ALDEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-07",
        "last_updated": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-10786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knewberry460598@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "10650 Park Rd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282108538",
            "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 Charlotte, NC

Sources for this page

Verify at the official NPI Registry.