NPIMap

Individual provider Active NPI

Janice Kunnakkattu, NP-C

  • Family Nurse Practitioner
  • Waxhaw, NC
National Provider Identifier
1902358831
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5012908 Issued in NC
Practice address
2700 S Providence Rd Ste 300
Waxhaw, NC 28173-6314
Phone
(704) 243-2254
Fax
(704) 243-2339
NPI assigned
Oct 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5012908 NC Primary
Family Nurse Practitioner 363LF0000X CNP 4850 MN

Addresses

Primary practice location

2700 S Providence Rd Ste 300
Waxhaw, NC 28173-6314

Mailing address

2700 S Providence Rd Ste 300
Waxhaw, NC 28173-6314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200511001734 NC Practitioner - Nurse Practitioner 2264712306 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
Telehealth
Offers telehealth services
Group practices
Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

251 Eastway Dr
Charlotte, NC 28213-7103
Phone (704) 446-9991

2700 Providence Rd S
Suite 300
Waxhaw, NC 28173-6314
Phone (704) 631-0002

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Atrium Health Union Hospital, Monroe, NC, CCN 340130

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
85.46 of 100Reported as group
Quality
80.45
Improvement activities
40
Cost
87.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CNP 4850MNMDFamily Nurse Practitioner
5012908NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 3, 2025 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 3, 2025 Accepting new patients
Carolinas Medical Center CurrentSince Dec 11, 2023 Accepting new patients
Carolinas Medical Center CurrentSince Dec 11, 2023 Accepting new patients
Grand St Paul CVS LLC Past Accepting new patients
Grand St Paul CVS LLC Past Accepting new patients

Locations

251 Eastway Dr
Charlotte, NC 28213
Phone (704) 446-9991

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

2700 S Providence Rd
Ste 300
Waxhaw, NC 28173
Phone (704) 243-2254

Interoperability endpoints

  • Direct secure messaging: jkunnakkattu2750293@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 7

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": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1902358831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 S PROVIDENCE RD STE 300",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281736314",
            "fax_number": "704-243-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 S PROVIDENCE RD STE 300",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281736314",
            "telephone_number": "704-243-2254",
            "fax_number": "704-243-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNNAKKATTU",
        "first_name": "JANICE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5012908",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP 4850",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxhaw, NC

Sources for this page

Verify at the official NPI Registry.