Individual provider Active NPI

Kelly B St. George, FNP

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1881900595
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5004843 Issued in NC
Practice address
10620 Park Rd
Ste 202
Charlotte, NC 28210-8472
Phone
(704) 667-0920
NPI assigned
Aug 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5004843 NC
Family Nurse Practitioner 363LF0000X 5004843 NC Primary

Addresses

Primary practice location

10620 Park Rd
Ste 202
Charlotte, NC 28210-8472

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1100 Blythe Blvd
Charlotte, NC 28203-5814
Phone (704) 355-4300

Other practice location 2

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

Other practice location 3

2301 US Highway 74 W
Wadesboro, NC 28170-7554
Phone (704) 994-4500

Other practice location 4

201 E Grover St
Shelby, NC 28150-3917
Phone (980) 487-3000

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address kstgeorge105906@CarolinasHealthcareSystem.direct-ci.com Atrium Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100915000649 NC Practitioner - Nurse Practitioner 3971628835 Reassigns benefits to 2 organizations
I20251229000110 GA Practitioner - Nurse Practitioner 3971628835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
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)

10620 Park Rd
Charlotte, NC 28210-0106

14214 Ballantyne Lake Rd
Charlotte, NC 28277-3373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Current Accepting new patients
Floyd Healthcare Management Inc Family CurrentSince Oct 4, 2025 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 15, 2014 Accepting new patients
Arboretum Urgent Care Center CurrentSince Dec 15, 2014 Accepting new patients
Floyd Healthcare Management Inc CurrentSince Oct 4, 2025 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 15, 2014 Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients

Locations (25 of 29)

1025 N Main St
Cedartown, GA 30125
Phone (770) 748-5212

990 Veterans Memorial Hwy NE
#A
Rome, GA 30161
Phone (706) 291-4100

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

420 Park St
Belmont, NC 28012
Phone (704) 631-1820

2709 Water Ridge Pkwy
Ste 500
Charlotte, NC 28217
Phone (704) 446-9173

5727 Prosperity Crossing Dr
Ste 1100
Charlotte, NC 28269
Phone (704) 863-9930

6025 Blakeney Park Dr
Ste 100
Charlotte, NC 28277
Phone (704) 667-4480

10210 Couloak Dr
Ste E
Charlotte, NC 28216
Phone (704) 801-2000

5717 Albemarle Rd
Charlotte, NC 28212
Phone (704) 563-2150

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

4525 Cameron Valley Pkwy
Ste 1500
Charlotte, NC 28211
Phone (704) 512-6240

231 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 304-6400

9332 S Tryon St
Charlotte, NC 28273
Phone (704) 587-6700

1100 Blythe Blvd
Charlotte, NC 28203
Phone (704) 355-4300

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

10620 Park Rd
Ste 202
Charlotte, NC 28210
Phone (704) 512-3988

1090 NE Gateway Ct NE
Ste 202
Concord, NC 28025
Phone (704) 403-9050

705 Griffith St
Ste 100
Davidson, NC 28036
Phone (704) 801-7900

12905 Rosedale Hill Ave
Huntersville, NC 28078
Phone (704) 801-1000

6030 W Highway 74
Ste A
Indian Trail, NC 28079
Phone (704) 246-2777

332 N Trade St
Ste 1100
Matthews, NC 28105
Phone (704) 512-6850

10545 Blair Rd
Ste 1200
Mint Hill, NC 28227
Phone (704) 667-2650

613 E Roosevelt Blvd
Monroe, NC 28112
Phone (704) 283-8193

3193 W Highway 74
Monroe, NC 28110
Phone (704) 689-4089

119 Market Place Ave
Ste D
Mooresville, NC 28117
Phone (704) 801-9140

Interoperability endpoints

  • Direct secure messaging: kstgeorge105906@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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1282176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1881900595",
    "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": "10620 PARK RD",
            "address_2": "STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108472",
            "telephone_number": "704-667-0920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Blythe Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035814",
            "country_code": "US",
            "telephone_number": "704-355-4300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Blythe Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035812",
            "country_code": "US",
            "telephone_number": "704-355-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2301 US Highway 74 W",
            "address_purpose": "LOCATION",
            "city": "Wadesboro",
            "state": "NC",
            "postal_code": "281707554",
            "country_code": "US",
            "telephone_number": "704-994-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 E Grover St",
            "address_purpose": "LOCATION",
            "city": "Shelby",
            "state": "NC",
            "postal_code": "281503917",
            "country_code": "US",
            "telephone_number": "980-487-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ST. GEORGE",
        "first_name": "KELLY",
        "middle_name": "B",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-19",
        "last_updated": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5004843",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5004843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "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"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kstgeorge105906@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "10620 Park Rd",
            "address_2": "Ste 202",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282108472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.