KELLI ANNE WALL
NPI 1639760945
Physician Assistant in Charlotte, NC

Q: What is Kelli Wall's NPI number?

The NPI number for Kelli Wall is 1639760945. It was assigned to this individual provider in the NPPES registry on January 29, 2021.

Q: What is Kelli Wall's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelli Wall was last updated on November 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.

Active since January 29, 2021PECOS EnrolledAccepts Medicare Assignment

325 HAWTHORNE LN STE 100, CHARLOTTE, NC 28204(704) 316-7760 Get Directions Write a Review

NPPES record last updated: November 14, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 14, 2025, May 12, 2022, Jan 29, 2021 (3 updates tracked since 2021).

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About Kelli Anne Wall NPPES

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

KELLI ANNE WALL (NPI 1639760945) is an individual physician assistant in Charlotte, North Carolina, licensed in North Carolina (0010-11928) and active in the NPI registry since January 2021. She is enrolled in Medicare PECOS, is affiliated with Novant Health Matthews Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1639760945

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKELLI ANNE WALL

Location Address325 HAWTHORNE LN STE 100Charlotte, NC 28204-2536

Mailing AddressPo Box 60447Charlotte, NC 28260-0447

Phone(704) 316-7760

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateJanuary 29, 2021

Last NPPES UpdateNovember 14, 20253 updates tracked since enumeration

NPPES CertifiedNovember 14, 2025

✔ NPI 1639760945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in NC · 0010-11928

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

325 HAWTHORNE LN STE 100, Charlotte, NC 28204

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Secondary Practice Locations 2

Location 114837 Cane Field DrCharlotte, NC 28273-8848 · Phone (352) 942-4010

Location 21450 Matthews Township Pkwy Ste 450Matthews, NC 28105-5343 · Phone (704) 384-8480 · Fax (704) 384-8481

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelli Anne Wall 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.

PECOS PAC ID8820485915

PECOS Enrollment IDI20220419002615

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.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

128 services71 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

54 services47 patients

Assessment of emotional or behavioral problems 96127

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

33 services33 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

29 services29 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

25 services15 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

24 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Novant Health Matthews Medical Center

Acute Care Hospitals · Matthews, NC

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number340171

Location1500 Matthews Twnshp Prkwy Box 3310Matthews, NC 28106 · Mecklenburg County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28204 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

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

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.

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