Kimberly Spain, FNP - Medicare Nurse Practitioner in Charlotte, NC

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Kimberly Spain, FNP is a medicare enrolled "Nurse Practitioner" in Charlotte, North Carolina. Her current practice location is 14214 Ballantyne Lake Rd, Ste 100, Charlotte, North Carolina. You can reach out to her office (for appointments etc.) via phone at (704) 667-2650.

Kimberly Spain is licensed to practice in North Carolina (license number 5011041) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1104312396.

Contact Information

Kimberly Spain, FNP
14214 Ballantyne Lake Rd, Ste 100,
Charlotte, NC 28277-3372
(704) 667-2650
Not Available

Map and Direction




Provider's Profile

Full NameKimberly Spain
GenderFemale
SpecialityNurse Practitioner
Location14214 Ballantyne Lake Rd, Charlotte, North Carolina
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1104312396
  • Provider Enumeration Date: 07/10/2018
  • Last Update Date: 01/20/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 0547505893
  • Enrollment ID: I20181214002028

Medical Identifiers

Medical identifiers for Kimberly Spain such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104312396NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner 5011041 (North Carolina)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kimberly Spain allows following entities to bill medicare on her behalf.
Entity NameCarolinas Physicians Network Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1437607686
PECOS PAC ID: 3375449655
Enrollment ID: O20040115000819
Entity NameEastland Urgent Care
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1467481127
PECOS PAC ID: 6305852591
Enrollment ID: O20060224000538
Entity NameArboretum Urgent Care Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457380313
PECOS PAC ID: 8325059991
Enrollment ID: O20060510000344
Entity NameSteele Creek Urgent Care
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750317921
PECOS PAC ID: 9234130907
Enrollment ID: O20070123000481
Entity NameEmergency Medicine Physicians Of Mecklenburg County Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1912232182
PECOS PAC ID: 3870635584
Enrollment ID: O20100119000374
Entity NameObservation Medicine Physicians Of Mecklenburg County Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1982075388
PECOS PAC ID: 8022313832
Enrollment ID: O20160216001560

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimberly Spain is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kimberly Spain, FNP
Po Box 19305,
Charlotte, NC 28219-9305

Ph: () -		Kimberly Spain, FNP
14214 Ballantyne Lake Rd, Ste 100,
Charlotte, NC 28277-3372

Ph: (704) 667-2650

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.