Individual provider Active NPI

Kathleen Tucker, RD

  • Registered Dietitian
  • Charlotte, NC
National Provider Identifier
1992213193
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L005193 Issued in NC
Practice address
4525 Cameron Valley Pkwy
Ste 4100
Charlotte, NC 28211-4369
Phone
(704) 302-9462
NPI assigned
Jan 22, 2018
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X L005193 NC Primary

Addresses

Primary practice location

4525 Cameron Valley Pkwy
Ste 4100
Charlotte, NC 28211-4369

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

270 Copperfield Blvd NE
Ste 102
Concord, NC 28025-2441
Phone (704) 786-6521

Other practice location 2

4315 Physicians Blvd
Ste 101
Harrisburg, NC 28075-7430
Phone (704) 455-6521

Other practice location 3

1025 Morehead Medical Dr
Ste 450
Charlotte, NC 28204-2963
Phone (704) 446-7800

Other practice location 4

8560 Cook St
Mount Pleasant, NC 28124-7686
Phone (704) 436-6521

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ktucker235811@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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180312002403 NC Practitioner - Registered Dietitian Or Nutrition Professional 5890057707 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

4525 Cameron Valley Pkwy
Suite 4100
Charlotte, NC 28211-4378
Phone (704) 355-5100

8560 Cook St
Mt Pleasant, NC 28124-7686
Phone (704) 436-6521

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Jan 20, 2022 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jan 30, 2018 Accepting new patients
Carolinas Physicians Network Inc Dietitian, Registered CurrentSince Jan 15, 2018 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 15, 2018 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jan 30, 2018 Accepting new patients

Locations

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

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

1025 Morehead Medical Dr
Ste 450
Charlotte, NC 28204
Phone (704) 446-7800

1001 Blythe Blvd
Ste 500
Charlotte, NC 28203
Phone (704) 355-5100

1025 Morehead Medical Dr
Ste 400
Charlotte, NC 28204

4525 Cameron Valley Pkwy
Ste 4100
Charlotte, NC 28211
Phone (704) 302-9300

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

270 Copperfield Blvd NE
Ste 102
Concord, NC 28025
Phone (704) 721-2060

1085 NE Gateway Ct NE
Ste 330
Concord, NC 28025
Phone (704) 403-8320

4315 Physicians Blvd
Ste 101
Harrisburg, NC 28075
Phone (704) 455-6521

332 N Trade St
#2000
Matthews, NC 28105
Phone (704) 302-8500

10545 Blair Rd
Ste 200
Mint Hill, NC 28227
Phone (704) 863-9500

1550 Faulk St
Ste 1500
Monroe, NC 28112
Phone (704) 302-9700

8560 Cook St
Mt Pleasant, NC 28124
Phone (704) 403-1911

Interoperability endpoints

  • Direct secure messaging: ktucker235811@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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1992213193",
    "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": "4525 CAMERON VALLEY PKWY",
            "address_2": "STE 4100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114369",
            "telephone_number": "704-302-9462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "270 Copperfield Blvd NE",
            "address_2": "Ste 102",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252441",
            "country_code": "US",
            "telephone_number": "704-786-6521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4315 Physicians Blvd",
            "address_2": "STE 101",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "NC",
            "postal_code": "280757430",
            "country_code": "US",
            "telephone_number": "704-455-6521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 Morehead Medical Dr",
            "address_2": "Ste 450",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042963",
            "country_code": "US",
            "telephone_number": "704-446-7800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8560 Cook St",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "NC",
            "postal_code": "281247686",
            "country_code": "US",
            "telephone_number": "704-436-6521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "KATHLEEN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-22",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L005193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ktucker235811@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "4525 Cameron Valley Pkwy",
            "address_2": "Ste 4100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282114369",
            "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 Charlotte, 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.
  • 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.