Individual provider Active NPI

Edward Kim, MD

  • Medical Oncology Physician
  • Charlotte, NC
National Provider Identifier
1972688984
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
2013-00241 Issued in NC
Practice address
1021 Morehead Medical Dr
Ste a
Charlotte, NC 28204-2990
Phone
(980) 442-2000
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 2013-00241 NC Primary

Addresses

Primary practice location

1021 Morehead Medical Dr
Ste a
Charlotte, NC 28204-2990

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

100 Medical Park Dr
Ste 110
Concord, NC 28025-2948
Phone (704) 403-6826

Other practice location 2

945 N 5th St
Albemarle, NC 28001-3417
Phone (980) 323-7790

Other practice location 3

4525 Cameron Valley Pkwy
Ste 3500
Charlotte, NC 28211-4369
Phone (704) 302-8300

Other practice location 4

1550 Faulk St
Monroe, NC 28112-5086
Phone (980) 442-0430

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130708000796 NC Practitioner - Medical OncologyPractitioner - Internal Medicine 1254526866 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority Medical Oncology CurrentSince Apr 10, 2013 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Apr 10, 2013 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Medical Oncology Current Accepting new patients

Locations

945 N 5th St
Albemarle, NC 28001
Phone (980) 323-7790

4525 Cameron Valley Pkwy
Ste 3500
Charlotte, NC 28211
Phone (704) 302-8300

1021 Morehead Medical Dr
Ste A
Charlotte, NC 28204
Phone (704) 355-2884

100 Medical Park Dr
Ste 110
Concord, NC 28025
Phone (704) 403-1370

1550 Faulk St
Monroe, NC 28112
Phone (980) 442-0430

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1972688984",
    "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": "1021 MOREHEAD MEDICAL DR",
            "address_2": "STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042990",
            "telephone_number": "980-442-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Medical Park Dr",
            "address_2": "STE 110",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252948",
            "country_code": "US",
            "telephone_number": "704-403-6826",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "945 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Albemarle",
            "state": "NC",
            "postal_code": "280013417",
            "country_code": "US",
            "telephone_number": "980-323-7790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4525 Cameron Valley Pkwy",
            "address_2": "Ste 3500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282114369",
            "country_code": "US",
            "telephone_number": "704-302-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1550 Faulk St",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "NC",
            "postal_code": "281125086",
            "country_code": "US",
            "telephone_number": "980-442-0430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NC",
            "license": "2013-00241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.