KATHLEEN WUNDER PERSAVICH MD
NPI 1689808123
Obstetrics & Gynecology in Charlotte, NC

Q: What is Kathleen Persavich's NPI number?

The NPI number for Kathleen Persavich is 1689808123. It was assigned to this individual provider in the NPPES registry on May 13, 2009.

Q: What is Kathleen Persavich's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Active since May 13, 2009PECOS EnrolledAccepts Medicare Assignment

2400 SOUTH BLVD STE 103, CHARLOTTE, NC 28203(704) 316-3000(704) 316-3001 Get Directions Write a Review

NPPES record last updated: May 26, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 26, 2022, Oct 26, 2020, Apr 10, 2018 and 1 more (4 updates tracked since 2017).

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About Kathleen Wunder Persavich Md NPPES

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

KATHLEEN WUNDER PERSAVICH MD (NPI 1689808123) is an individual obstetrics & gynecology provider in Charlotte, North Carolina, licensed in North Carolina (2013-00887) and active in the NPI registry since May 2009. She is enrolled in Medicare PECOS, maintains a secondary practice location in Charlotte, and is a graduate of Indiana University School Of Medicine (2009).

NPPES Registry Identity

NPI1689808123

Entity TypeIndividualFemale

Primary Taxonomy207V00000X

Provider Legal NameKATHLEEN WUNDER PERSAVICHCredential: MD

Location Address2400 SOUTH BLVD STE 103Charlotte, NC 28203-5773

Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (704) 316-3000 · Fax (704) 316-3001

Phone(704) 316-3000

Fax(704) 316-3001

Sole ProprietorNo

Medical School CMSIndiana University School Of MedicineGraduated 2009

Enumeration DateMay 13, 2009

Last NPPES UpdateMay 26, 20224 updates tracked since enumeration

NPPES CertifiedMay 10, 2022

✔ NPI 1689808123 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

Licenses✔ Licensed in NC · 2013-00887✔ Licensed in NC · 157376

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

2400 SOUTH BLVD STE 103, Charlotte, NC 28203

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Secondary Practice Location 1

Location 12100 S Tryon St, Ste 201Charlotte, NC 28203-4958 · Phone (704) 316-3000 · Fax (704) 316-3001

Other Identifiers 1

Medicaid1689808123NC

Accepted Insurance

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

Kathleen Wunder Persavich 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.

PECOS PAC ID3678715836

PECOS Enrollment IDI20130819000061

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.

Medicare Billing Reassignment

Medicare enrollment records show Kathleen Persavich reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Novant Health Medical Group, LLC

Same address

Family Medicine

2400 SOUTH BLVD STE 103
Charlotte, NC 28203

Reassigned Medicare billing, North Carolina enrollment
Also billed through NPI 1114171634 (North Carolina)
2,998 clinicians in this Medicare group

NPI 1912447079 (704) 316-3017

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 28203 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

$125.01 typical visit price

range $54.12 – $165.09

Typical copayment $31.25 (range $13.53 – $41.27)

Most-billed visit code 99204

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 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MERCEDES LAUREL STANLEY DNP, CPNP

Nurse Practitioner