STEPHANIE PETTUS KWON MD
NPI 1063772374
Pediatrics in Charlotte, NC
About Stephanie Pettus Kwon Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STEPHANIE PETTUS KWON MD (NPI 1063772374) is an individual pediatrics provider in Charlotte, North Carolina, licensed in North Carolina (2015-00556) and active in the NPI registry since May 2012. She is enrolled in Medicare PECOS, maintains 4 additional practice locations, and is a graduate of Medical University Of South Carolina College Of Medicine (2012).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 4
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Stephanie Pettus Kwon Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
3Medicare enrollment records show Stephanie Kwon reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Charlotte, NC 28211
- Reassigned Medicare billing, North Carolina enrollment
- 2,057 clinicians in this Medicare group
Charlotte, NC 28211
- Reassigned Medicare billing, North Carolina enrollment
- 2,223 clinicians in this Medicare group
Mint Hill, NC 28227
- Reassigned Medicare billing, North Carolina enrollment
- 30 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 28211 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CHARLOTTE, NC 28211
CHARLOTTE, NC 28211
CHARLOTTE, NC 28211
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Stephanie Kwon's NPI number?
The NPI number for Stephanie Kwon is 1063772374. It was assigned to this individual provider in the NPPES registry on May 21, 2012.
Where is Stephanie Kwon located?
Stephanie Kwon practices at 4501 Cameron Valley Pkwy Ste 100, Charlotte, NC 28211. The listed phone number is (704) 367-7400.
What is Stephanie Kwon's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Stephanie Kwon enrolled in Medicare?
Yes. Stephanie Kwon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Stephanie Kwon's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Stephanie Kwon reassigns Medicare benefits to 3 organizations: Carolinas Physicians Network Inc (Charlotte, NC), Carolinas Medical Center (Charlotte, NC) and University Pediatrics (Mint Hill, NC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Stephanie Kwon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Stephanie Kwon accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and Blue Cross and Blue Shield of NC and 4 other insurers list Stephanie Kwon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Stephanie Kwon was last updated on July 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Stephanie Pettus Kwon, MD · NPI 1063772374
Pediatrics physician in Charlotte, North Carolina. Individual provider, active in the CMS NPPES registry since May 21, 2012.
## Identity
- **NPI:** 1063772374 (Entity type: Individual)
- **Enumerated:** May 21, 2012
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** 2015-00556 (North Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 4501 CAMERON VALLEY PKWY, STE 100, Charlotte, NC 28211-4297
- **Phone:** (704) 367-7400
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Carolinas Physicians Network Inc (NPI 1215573423, Charlotte, NC); Carolinas Medical Center (NPI 1942539010, Charlotte, NC); University Pediatrics (NPI 1609102649, Mint Hill, NC) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Medical University Of South Carolina College Of Medicine, class of 2012
## Record status
- **NPPES last updated:** July 15, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1063772374) · Data from the CMS NPPES public registry.