NPIMap

Individual provider Active NPI

Rebecca Lynn Kelso

  • Vascular Surgery Physician
  • Charlotte, NC
National Provider Identifier
1902928799
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
2018-00611 Issued in NC
Practice address
125 Queens Rd Ste 250
Charlotte, NC 28204-3215
Phone
(704) 316-5100
Fax
(704) 316-5101
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A82292 CA
Surgery Physician 208600000X 2018-00611 NC
Vascular Surgery Physician 2086S0129X 094030 OH
Vascular Surgery Physician 2086S0129X 2018-00611 NC Primary

Addresses

Primary practice location

125 Queens Rd Ste 250
Charlotte, NC 28204-3215

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-5100

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rkelso544952@direct.novanthealth.org
Direct Messaging Address rkelso544952@direct.novanthealth.org

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
I20180615002143 NC Practitioner - Vascular SurgeryPractitioner - General Surgery 7113072000 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

301 Hawthorne LN
Suite 200
Charlotte, NC 28204-2467
Phone (704) 316-5100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion146
Varicose vein removal1-10
Leg revascularization (restoring blood flow)17
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A82292CAMDSurgery Physician
094030OHMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Rowan Regional Medical Center CurrentSince Sep 23, 2018 Accepting new patients
The Presbyterian Hospital CurrentSince May 25, 2018 Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 25, 2018 Accepting new patients
Novant Health Rowan Medical Center, LLC CurrentSince Sep 23, 2018 Accepting new patients
The Presbyterian Hospital CurrentSince May 25, 2018 Accepting new patients
Novant Health Rowan Medical Center LLC Current Accepting new patients
The Presbyterian Hospital Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Medical Group, Inc CurrentSince May 25, 2018 Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 25, 2018 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

8201 Healthcare Loop
Ste 201
Charlotte, NC 28215
Phone (704) 316-3024

125 Queens Rd
Ste 330
Charlotte, NC 28204
Phone (704) 384-5043

125 Queens Rd
Charlotte, NC 28204
Phone (980) 302-6450

125 Baldwin Ave
Ste 200
Charlotte, NC 28204
Phone (704) 384-5043

2225 Freedom Dr
Charlotte, NC 28208
Phone (704) 316-5166

15830 Ballantyne Medical Pl
Ste 275
Charlotte, NC 28277
Phone (980) 302-8659

125 Queens Rd
Ste 200
Charlotte, NC 28204

301 Hawthorne Ln
Ste 200
Charlotte, NC 28204
Phone (704) 316-5100

125 Queens Rd
Ste 250
Charlotte, NC 28204
Phone (704) 316-2340

9930 Kincey Ave
Ste 200
Huntersville, NC 28078
Phone (704) 887-4530

1401 Matthews Township Pkwy
Ste 110
Matthews, NC 28105
Phone (704) 264-3500

1401 Matthews Township Pkwy
Ste 212312
Matthews, NC 28105
Phone (704) 316-3131

911 W Henderson St
Ste 230
Salisbury, NC 28144
Phone (704) 210-5000

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: rkelso544952@direct.novanthealth.org

Organizations & group practices 13

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.

View all 13

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1902928799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-316-5100",
            "fax_number": "704-316-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD STE 250",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043215",
            "telephone_number": "704-316-5100",
            "fax_number": "704-316-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSO",
        "first_name": "REBECCA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A82292",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2018-00611",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": "094030",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NC",
            "license": "2018-00611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkelso544952@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "301 Hawthorne Ln Ste 200",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042467",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkelso544952@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "125 Queens Rd Ste 250",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.