Individual provider Active NPI

Amy Zickefoose Kupsco, FNP

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1962093195
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F01211463 Issued in NC
Practice address
3158 Freedom Dr Ste 3101
Charlotte, NC 28208-0014
Phone
(704) 348-2992
NPI assigned
Jan 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F01211463 NC Primary

Addresses

Primary practice location

3158 Freedom Dr Ste 3101
Charlotte, NC 28208-0014

Mailing address

PO Box 37938
Charlotte, NC 28237-7938
Phone (704) 332-0396

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address akupsco66455@direct.acumenmd.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210326000433 NC Practitioner - Nurse Practitioner 5496162067 Reassigns benefits to 2 organizations
I20221203000342 SC Practitioner - Nurse Practitioner 5496162067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians
Metrolina Nephrology Associates PAGroup PAC ID 8022916600, 85 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000

1025 Morehead Medical Dr
Suite 275a
Charlotte, NC 28204-2963
Phone (704) 355-0607

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 355-7328

1975 Carolna Place Dr
Fort Mill, SC 29708-6922
Phone (704) 348-2992

3158 Freedom Dr
Suite 3101
Charlotte, NC 28208-0014
Phone (704) 348-2992

Hospital & facility affiliations

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F01211463NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center Current Accepting new patients
Carolinas Medical Center CurrentSince Aug 5, 2021 Accepting new patients
Metrolina Nephrology Associates, PA CurrentSince Apr 5, 2021 Accepting new patients
Carolinas Medical Center CurrentSince Aug 5, 2021 Accepting new patients

Locations

2711 Randolph Rd
Ste 400
Charlotte, NC 28207
Phone (704) 342-1900

3158 Freedom Dr
Ste 3101
Charlotte, NC 28208

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

3158 Freedom Dr
Ste 3102
Charlotte, NC 28208
Phone (704) 731-6857

2544 Court Dr
Ste F
Gastonia, NC 28054
Phone (704) 864-8302

1975 Carolna Place Dr
Fort Mill, SC 29708
Phone (803) 802-3027

Interoperability endpoints

  • Direct secure messaging: akupsco66455@direct.acumenmd.com
  • Direct secure messaging: akupsco50500@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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": "1611964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1962093195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37938",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282377938",
            "telephone_number": "704-332-0396",
            "fax_number": "704-971-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3158 FREEDOM DR STE 3101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282080014",
            "telephone_number": "704-348-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPSCO",
        "first_name": "AMY",
        "middle_name": "ZICKEFOOSE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-30",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F01211463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akupsco66455@direct.acumenmd.com",
            "affiliation": "N",
            "endpointDescription": "Acumen Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CED",
            "address_1": "3158 Freedom Dr Ste 3101",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282080014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.