Active NPI
Kendra Rene Richardson, MD
- Family Medicine Physician
- Mount Holly, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2015-01954
- Practice address
- 215 S Main St
Ste 100
Mount Holly, NC 28120-1620 - Phone
- (704) 302-8555
- NPI assigned
- May 23, 2014
- Last updated
- Jul 15, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2015-01954 | NC | Primary |
| Sleep Medicine (Family Medicine) Physician | 207QS1201X | 2015-01954 | NC | |
| Sleep Medicine (Internal Medicine) Physician | 207RS0012X | 2015-01954 | NC |
Addresses
Primary practice location
215 S Main St
Ste 100
Mount Holly, NC 28120-1620
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Other practice location 1
101 E W T Harris Blvd
Ste 3301-B
Charlotte, NC 28262-3485
Phone (704) 302-8555
Other practice location 2
10650 Park Rd
Ste 330
Charlotte, NC 28210-8538
Phone (704) 302-8555
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
| Direct Messaging Address | krichardson1236670@CarolinasHealthcareSystem.direct-ci.com | Atrium Health |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Meharry Medical College School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
215 S Main St
Suite 100
Mt Holly, NC 28120-1620
Phone (704) 302-8555
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015-01954 | NC | MD | Sleep Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Caromont Medical Group Inc | Family Medicine | Current | Accepting new patients |
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| Caromont Medical Group Inc | Family Medicine | Current | Accepting new patients |
| Carolinas Physicians Network Inc | Sleep Medicine | Current | Accepting new patients |
| Carolinas Physicians Network Inc. | Past | Accepting new patients |
Locations
100 N 6th St
Ste 900A
Minneapolis, MN 55403
101 E Wt Harris Blvd
Ste 3301B
Charlotte, NC 28262
10650 Park Rd
Ste 330
Charlotte, NC 28210
Phone (704) 468-8877
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
2001 Vail Ave
Fl 4
Charlotte, NC 28207
Phone (704) 304-7000
2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662
215 S Main St
Ste 100
Mt Holly, NC 28120
1200 Village Harbor Dr
Lake Wylie, SC 29710
Phone (704) 671-6400
1200 Village Harbor Dr
Ste D
Lake Wylie, SC 29710
Phone (704) 671-6400
Interoperability endpoints
- krichardson1236670@carolinashealthcaresystem.direct-ci.com
Organizations & group practices 6
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.
-
dba Atrium Health Musculoskeletal Institute Orthopedics & Sports Medici
- Orthopaedic Surgery Physician
- Charlotte, NC
- NPI 1437607686
-
- Family Medicine Physician
- Gastonia, NC
- NPI 1356314272
-
dba Atrium Health Diabetes Prevention
- Endocrinology, Diabetes & Metabolism Physician
- Charlotte, NC
- NPI 1437038544
-
dba Atrium Health Sleep Medicine
- Sleep Medicine (Internal Medicine) Physician
- Kings Mountain, NC
- NPI 1558702191
-
dba CaroMont Urgent Care
- Family Medicine Physician
- Charlotte, NC
- NPI 1447598701
-
dba Atrium Health Imaging - Kenilworth
- Vascular Surgery Physician
- Charlotte, NC
- NPI 1881624807
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital
- Charlotte, NC
- NPI 1790727550
Inpatient rehabilitation facility
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721001600000",
"number": "1932511078",
"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": "215 S MAIN ST",
"address_2": "STE 100",
"city": "MOUNT HOLLY",
"state": "NC",
"postal_code": "281201620",
"telephone_number": "704-302-8555"
}
],
"practiceLocations": [
{
"address_1": "101 E W T Harris Blvd",
"address_2": "Ste 3301-B",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282623485",
"country_code": "US",
"telephone_number": "704-302-8555",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "10650 Park Rd",
"address_2": "Ste 330",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282108538",
"country_code": "US",
"telephone_number": "704-302-8555",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RICHARDSON",
"first_name": "KENDRA",
"middle_name": "RENE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-23",
"last_updated": "2024-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "2015-01954",
"primary": true
},
{
"code": "207QS1201X",
"taxonomy_group": "",
"desc": "Family Medicine, Sleep Medicine",
"state": "NC",
"license": "2015-01954",
"primary": false
},
{
"code": "207RS0012X",
"taxonomy_group": "",
"desc": "Internal Medicine, Sleep Medicine",
"state": "NC",
"license": "2015-01954",
"primary": false
}
],
"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": "krichardson1236670@CarolinasHealthcareSystem.direct-ci.com",
"affiliation": "Y",
"affiliationName": "Atrium Health",
"address_1": "215 S Main St",
"address_2": "Ste 100",
"city": "Mount Holly",
"state": "NC",
"country_code": "US",
"postal_code": "281201620",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Mount Holly, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.