Individual provider Active NPI

Kimberly Williams Roberts, FNP

  • Family Nurse Practitioner
  • Shelby, NC
National Provider Identifier
1912379157
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5007868 Issued in NC
Practice address
1010 E Dixon Blvd
Shelby, NC 28152-6838
Phone
(980) 487-2700
NPI assigned
Oct 28, 2015
Last updated
Jul 15, 2024By the provider in NPPES
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 5007868 NC
Family Nurse Practitioner 363LF0000X 5007868 NC Primary

Addresses

Primary practice location

1010 E Dixon Blvd
Shelby, NC 28152-6838

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

447 McAlister Rd
Ste 2400
Lincolnton, NC 28092-4114
Phone (980) 487-2700

Other practice location 2

441 McAlister Rd
Lincolnton, NC 28092-4126
Phone (980) 487-2700

Other practice location 3

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-4490

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kroberts263572@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
I20160222000947 NC Practitioner - Nurse Practitioner 7911202411 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
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)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2165

1106 Reynolds St
Suite 100
Monroe, NC 28112-4376
Phone (704) 289-5443

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

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5007868NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 24, 2016 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 24, 2016 Accepting new patients
Carolinas Pathology Group, PA Current Accepting new patients
Carolinas Medical Center CurrentSince Nov 7, 2016 Accepting new patients
Carolinas Medical Center CurrentSince Nov 7, 2016 Accepting new patients
Carolinas Physicians Network Inc. Family Past Accepting new patients

Locations

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

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

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

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

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

441 McAlister Rd
Lincolnton, NC 28092
Phone (980) 212-4000

447 McAlister Rd
Ste 2400
Lincolnton, NC 28092
Phone (980) 212-6500

1106 Reynolds St
Ste 100
Monroe, NC 28112
Phone (704) 289-5443

2209 S Sterling St
Ste 530
Morganton, NC 28655
Phone (828) 580-4230

1010 E Dixon Blvd
Shelby, NC 28152
Phone (980) 487-2700

Interoperability endpoints

  • Direct secure messaging: kroberts263572@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1445990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1912379157",
    "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": "1010 E DIXON BLVD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281526838",
            "telephone_number": "980-487-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "447 McAlister Rd",
            "address_2": "Ste 2400",
            "address_purpose": "LOCATION",
            "city": "Lincolnton",
            "state": "NC",
            "postal_code": "280924114",
            "country_code": "US",
            "telephone_number": "980-487-2700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "441 McAlister Rd",
            "address_purpose": "LOCATION",
            "city": "Lincolnton",
            "state": "NC",
            "postal_code": "280924126",
            "country_code": "US",
            "telephone_number": "980-487-2700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-4490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KIMBERLY",
        "middle_name": "WILLIAMS",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-28",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5007868",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5007868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kroberts263572@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1010 E Dixon Blvd",
            "city": "Shelby",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281526838",
            "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 Shelby, NC

Sources for this page

Verify at the official NPI Registry.