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KIMBERLY SPAIN FNP
NPI 1104312396
Nurse Practitioner in Charlotte, NC

Active since July 10, 2018PECOS Enrolled
14214 BALLANTYNE LAKE RD, STE 100, CHARLOTTE, NC 28277(704) 667-2650 Get Directions Write a Review

NPPES record last updated: January 20, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 20, 2021, Jan 6, 2021, Dec 29, 2020 and 3 more (6 updates tracked since 2018).

About Kimberly Spain Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY SPAIN FNP (NPI 1104312396) is an individual nurse practitioner in Charlotte, North Carolina, licensed in North Carolina (5011041) and active in the NPI registry since July 2018. She is enrolled in Medicare PECOS and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1104312396
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameKIMBERLY SPAINCredential: FNP
Location Address14214 BALLANTYNE LAKE RD, STE 100Charlotte, NC 28277-3372
Mailing AddressPo Box 19305Charlotte, NC 28219-9305
Phone(704) 667-2650
Sole ProprietorNo
Enumeration DateJuly 10, 2018
Last NPPES UpdateJanuary 20, 20216 updates tracked since enumeration
✔ NPI 1104312396 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in NC · 5011041
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
14214 BALLANTYNE LAKE RD, Charlotte, NC 28277
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Secondary Practice Locations 4

Location 15727 Prosperity Crossing Dr, Ste 1100Charlotte, NC 28269-2206 · Phone (704) 863-9930
Location 27810 Providence Rd, Ste 102Charlotte, NC 28226-2954 · Phone (704) 543-6636
Location 35717 Albemarle RdCharlotte, NC 28212-1634 · Phone (704) 563-2150
Location 410210 Couloak Dr, Ste ECharlotte, NC 28216-7679 · Phone (704) 801-2000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kimberly Spain Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28277 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

PARDEEP KESRANI MD
Pediatrics
14214 BALLANTYNE LAKE RD, STE 300
CHARLOTTE, NC 28277
Mecklenburg County (704) 667-2600
MATTHEW RAYMOND SNOW PA
Physician Assistant
14214 BALLANTYNE LAKE RD, STE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 667-2650
BARNETT FAMILY PRACTICE
Family Medicine
14214 BALLANTYNE LAKE RD
CHARLOTTE, NC 28277
Mecklenburg County (803) 283-2011
ERIC DANIEL SENSENBRENNER DO
Internal Medicine
14214 BALLANTYNE LAKE RD, STE 150
CHARLOTTE, NC 28277
Mecklenburg County (704) 863-4878
PAUL SMOLEN
Pediatrics
14214 BALLANTYNE LAKE RD, SUITE 300
CHARLOTTE, NC 28277
Mecklenburg County (704) 667-2600
CAROLINAS MEDICAL CENTER
Pediatrics
14214 BALLANTYNE LAKE RD, SUITE 150
CHARLOTTE, NC 28277
Mecklenburg County (704) 667-2680
CORINNE SIROIS RD
Dietitian, Registered
14214 BALLANTYNE LAKE RD, STE 200
CHARLOTTE, NC 28277
Mecklenburg County (704) 667-2681
MONICA CHHEDA MILLER MD
Pediatrics
14214 BALLANTYNE LAKE RD, STE 300
CHARLOTTE, NC 28277
Mecklenburg County (704) 667-2600

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 Kimberly Spain's NPI number?

The NPI number for Kimberly Spain is 1104312396. It was assigned to this individual provider in the NPPES registry on July 10, 2018.

Where is Kimberly Spain located?

Kimberly Spain practices at 14214 Ballantyne Lake Rd Ste 100, Charlotte, NC 28277. The listed phone number is (704) 667-2650.

What is Kimberly Spain's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Kimberly Spain enrolled in Medicare?

Yes. Kimberly Spain is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kimberly Spain was last updated on January 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.