Kim Marion Carollo, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

5012470 Issued in NC

Practice address

3643 N Roxboro St
Durham, NC 27704-2702

Phone

(919) 470-6248

NPI assigned

Nov 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Carolinas Physicians Network Inc 2,324 clinicians

Carolinas Medical Center 1,057 clinicians

Wakemed Specialists Group LLC 868 clinicians

Duke Health Integrated Practice Inc 3,140 clinicians

Prisma Health Medical Group-Midlands 1,040 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Duke Regional Hospital Hospital, Durham, NC, CCN 340155
• Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kcarollo497796@direct.medicine.duke.edu
• Direct secure messaging: kcarollo289155@direct.ghs.myhfn.org
• Direct secure messaging: kcarollo208610@direct.unc.nchie.net
• Direct secure messaging: kcarollo44406@carolinashealthcaresystem.direct-ci.com

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.

• Carolinas Medical Center

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
  • NPI 1275774333

  NC

  Medicare reassignment Care Compare group NPD
• Duke Health Integrated Practice, Inc.

  • General Practice Physician
  • Durham, NC
  • NPI 1205553369

  NC

  Medicare reassignment Care Compare group NPD
• Wakemed Specialists Group, LLC

  • Cardiovascular Disease Physician
  • Raleigh, NC
  • NPI 1588227839

  NC

  Medicare reassignment Care Compare group NPD
• Prisma Health Medical Group-Midlands

  • Multi-Specialty Clinic/Center
  • Columbia, SC
  • NPI 1275988321

  SC

  Medicare reassignment Care Compare group NPD
• Caldwell Memorial Hospital, Inc

  • Cardiovascular Disease Physician
  • Lenoir, NC
  • NPI 1477839108

  NC

  Medicare reassignment NPD
• Carolinas Physicians Network Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Charlotte, NC
  • NPI 1477878890

  NC

  Medicare reassignment NPD
• Columbus Regional Health Network

  • Hospitalist Physician
  • Whiteville, NC
  • NPI 1508001009

  NC

  Medicare reassignment NPD
• Duke University Health System, Inc.

  • Certified Registered Nurse Anesthetist
  • Durham, NC
  • NPI 1558392977

  NC, Nurse Practitioner

  Medicare reassignment NPD
• Scotland Regional Health Network

  • Hospitalist Physician
  • Laurinburg, NC
  • NPI 1972829562

  NC

  Medicare reassignment NPD
• The Moses H Cone Memorial Hospital Operating Corporation

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1356372064

  NC

  Medicare reassignment NPD
• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032

  NC

  Medicare reassignment NPD
• Carolinas Medical Center

  • Community/Retail Pharmacy
  • Charlotte, NC
  • NPI 1982710554
  Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Duke University Health System Inc

  • Clinical Medical Laboratory
  • Durham, NC
  • NPI 1689656480

  Hospital

  Care Compare affiliation
• Duke University Health System, Inc.

  • General Acute Care Hospital
  • Durham, NC
  • NPI 1871592113

  Hospital

  Care Compare affiliation
• Wakemed

  • Psychiatric Hospital Unit
  • Raleigh, NC
  • NPI 1780446302

  Hospital

  Care Compare affiliation
• Wakemed

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1972579837

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1972072114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 N HARBOR WATCH DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286772483",
            "telephone_number": "516-316-5392",
            "fax_number": "516-316-5392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3643 N ROXBORO ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042702",
            "telephone_number": "919-470-6248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Richland Medical Park Dr Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036864",
            "country_code": "US",
            "telephone_number": "803-434-2762",
            "fax_number": "803-434-2713",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8 Richland Medical Park Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292038006",
            "country_code": "US",
            "telephone_number": "803-434-3800",
            "fax_number": "803-744-2759",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Blythe Blvd",
            "address_2": "CMC Annex, 1st Floor",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28203",
            "country_code": "US",
            "telephone_number": "704-355-0270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3000 New Bern Ave Ste G100",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276101231",
            "country_code": "US",
            "telephone_number": "919-231-6132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAROLLO",
        "first_name": "KIM",
        "middle_name": "MARION",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-16",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN282977",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "23520",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "5012470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP64661",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcarollo289155@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kcarollo289155@direct.ghs.myhfn.org",
            "address_1": "6 Richland Medical Park Dr Ste 2100",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292036864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carolina Vascular Wellness, PLLC
• Carolina Vein Center PLLC
• Carolina Women S Research and Wellness Center
• Carolina Women S Research and Wellness Center
• Carolinahearinggroupinc
• Madison Nicole Carollo, CPNP - AC
• Kelly Caron, PHD
• Michaela Caron, OTR/L
• Anna Carpenter
• Bryanna Ashlee Carpenter, MD, MPH

• All providers in Durham, NC
• Acute Care Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.

Verify at the official NPI Registry.