Kim Marion Carollo, NP - Medicare Nurse Practitioner in Charlotte, NC

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Kim Marion Carollo, NP is a medicare enrolled "Nurse Practitioner - Acute Care" in Charlotte, North Carolina. She graduated from nursing school in 2018 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Wakemed Specialists Group Llc, Carolinas Physicians Network Inc, Caldwell Memorial Hospital Inc, Duke Health Integrated Practice Inc and her current practice location is 1000 Blythe Blvd, Cmc Annex, 1st Floor, Charlotte, North Carolina. You can reach out to her office (for appointments etc.) via phone at (704) 355-0270.

Kim Marion Carollo is licensed to practice in North Carolina (license number 5012470) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1972072114.

Contact Information

Kim Marion Carollo, NP
1000 Blythe Blvd, Cmc Annex, 1st Floor,
Charlotte, NC 28203
(704) 355-0270
Not Available

Map and Direction




Provider's Profile

Full NameKim Marion Carollo
GenderFemale
SpecialityNurse Practitioner
Experience6 Years
Location1000 Blythe Blvd, Charlotte, North Carolina
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Kim Marion Carollo graduated from nursing school in 2018
  NPI Data:
  • NPI Number: 1972072114
  • Provider Enumeration Date: 11/16/2018
  • Last Update Date: 01/31/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 5496095697
  • Enrollment ID: I20200221002630

Medical Identifiers

Medical identifiers for Kim Marion Carollo such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1972072114NPI-NPPES
NP64661MedicaidSC

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LA2100XNurse Practitioner - Acute Care 23520 (South Carolina)Secondary
363LA2100XNurse Practitioner - Acute Care RN282977 (Georgia)Secondary
363LA2100XNurse Practitioner - Acute Care 5012470 (North Carolina)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Caldwell Memorial HospitalLenoir, NCHospital
Duke Regional HospitalDurham, NCHospital
Carolinas Medical Center/behav HealthCharlotte, NCHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Wakemed Specialists Group Llc2466788377701
Carolinas Physicians Network Inc33754496551649
Caldwell Memorial Hospital Inc5395646970167
Duke Health Integrated Practice Inc83254127372636

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. Kim Marion Carollo allows following entities to bill medicare on her behalf.
Entity NameThe Moses H Cone Memorial Hospital Operating Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1356372064
PECOS PAC ID: 6204744600
Enrollment ID: O20031124000541
Entity NameDuke University Health System Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1558392977
PECOS PAC ID: 2567372345
Enrollment ID: O20031201000521
Entity NamePrivate Diagnostic Clinic Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457389033
PECOS PAC ID: 1355254368
Enrollment ID: O20031204000577
Entity NameCarolinas Physicians Network Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1477878890
PECOS PAC ID: 3375449655
Enrollment ID: O20031219000455
Entity NameCaldwell Memorial Hospital Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1477839108
PECOS PAC ID: 5395646970
Enrollment ID: O20040116000355
Entity NameSt. Luke's Physician Network Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1205088796
PECOS PAC ID: 8224190277
Enrollment ID: O20081229000465
Entity NameColumbus Regional Health Network
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1508001009
PECOS PAC ID: 6608924931
Enrollment ID: O20090424000511
Entity NameScotland Regional Health Network
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1972829562
PECOS PAC ID: 2365573185
Enrollment ID: O20100623000242
Entity NameWakemed Specialists Group Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1588227839
PECOS PAC ID: 2466788377
Enrollment ID: O20190731000815
Entity NameDuke Health Integrated Practice Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1205553369
PECOS PAC ID: 8325412737
Enrollment ID: O20230327002247

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. Kim Marion Carollo 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
Kim Marion Carollo, NP
179 N Harbor Watch Dr,
Statesville, NC 28677-2483

Ph: (516) 316-5392		Kim Marion Carollo, NP
1000 Blythe Blvd, Cmc Annex, 1st Floor,
Charlotte, NC 28203

Ph: (704) 355-0270

Reviews and Comments


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Angela Devincent Booth, NP
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Practice Location: 1001 Blythe Blvd, Medical Center Plaza Suite 200, Charlotte, NC 28203
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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.