Individual provider Active NPI

Kayla Marie Marcinizyn, FNP

  • Family Nurse Practitioner
  • Concord, NC
National Provider Identifier
1891449047
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5015935 Issued in NC
Practice address
1054 Burrage Rd NE
Concord, NC 28025-2910
Phone
(704) 403-7800
NPI assigned
Feb 7, 2022
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5015935 NC
Family Nurse Practitioner 363LF0000X 5015935 NC Primary

Addresses

Primary practice location

1054 Burrage Rd NE
Concord, NC 28025-2910

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

16455 Statesville Rd
Ste 480
Huntersville, NC 28078-7135
Phone (704) 896-3370

Other practice location 2

7810 Providence Rd
Ste 101
Charlotte, NC 28226-2954
Phone (704) 446-1700

Other practice location 3

1025 Morehead Medical Dr
Ste 450
Charlotte, NC 28204-2963
Phone (704) 446-7800

Other practice location 4

7810 Providence Rd
Ste 105
Charlotte, NC 28226-2954
Phone (704) 446-7800

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kmarcinizyn630881@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220623000921 NC Practitioner - Nurse Practitioner 5294114161 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

1054 Burrage Rd NE
Concord, NC 28025-2910
Phone (704) 403-7800

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Family CurrentSince Apr 1, 2025 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jan 1, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Apr 1, 2025 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jan 1, 2024 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Past Accepting new patients
Eastover Obstetrics and Gynecology Associates Inc Past Accepting new patients

Locations

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

7810 Providence Rd
Ste 101
Charlotte, NC 28226
Phone (704) 373-1541

101 E Wt Harris Blvd
Ste 5301
Charlotte, NC 28262
Phone (704) 548-1671

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

7810 Providence Rd
Ste 105
Charlotte, NC 28226
Phone (704) 446-7800

9908 Couloak Dr
Ste 201
Charlotte, NC 28216
Phone (704) 801-2075

1901 South Blvd
Charlotte, NC 28203

1025 Morehead Medical Dr
Ste 400
Charlotte, NC 28204

5727 Prosperity Crossing Dr
Ste 2100
Charlotte, NC 28269
Phone (704) 863-9800

1025 Morehead Medical Dr
Ste 450
Charlotte, NC 28204
Phone (704) 446-7800

4525 Cameron Valley Pkwy
Ste 2500
Charlotte, NC 28211
Phone (704) 512-3800

1085 NE Gateway Ct NE
#200A
Concord, NC 28025
Phone (704) 403-8650

1054 Burrage Rd NE
Concord, NC 28025
Phone (704) 403-7800

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

2101 Shiloh Church Rd
Ste 202
Davidson, NC 28036
Phone (704) 403-7800

2101 Shiloh Church Rd
Ste 201
Davidson, NC 28036
Phone (704) 403-8650

16455 Statesville Rd
Ste 480
Huntersville, NC 28078
Phone (704) 896-3362

6030 W Highway 74
Ste B
Indian Trail, NC 28079
Phone (704) 289-2553

Interoperability endpoints

  • Direct secure messaging: kmarcinizyn630881@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 8

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 6

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": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1891449047",
    "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": "1054 BURRAGE RD NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252910",
            "telephone_number": "704-403-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16455 Statesville Rd",
            "address_2": "Ste 480",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787135",
            "country_code": "US",
            "telephone_number": "704-896-3370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7810 Providence Rd",
            "address_2": "Ste 101",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282262954",
            "country_code": "US",
            "telephone_number": "704-446-1700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 Morehead Medical Dr",
            "address_2": "Ste 450",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042963",
            "country_code": "US",
            "telephone_number": "704-446-7800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7810 Providence Rd",
            "address_2": "Ste 105",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282262954",
            "country_code": "US",
            "telephone_number": "704-446-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCINIZYN",
        "first_name": "KAYLA",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-07",
        "last_updated": "2024-07-15",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5015935",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5015935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmarcinizyn630881@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1054 Burrage Rd NE",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252910",
            "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.