KANITRA CLYBURN (NPI# 1497131031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497131031 |
| Entity Type | Individual |
| Full Name | KANITRA CLYBURN |
| Credential | NP |
| Practice Address |
13640 Steelecroft Pkwy Ste 210 Charlotte NC 28278-7565 |
| Mailing Address |
Po Box 19305 Charlotte NC 28219-9305 |
| Practice Telephone | 7045126100 |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2020-09-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 5007846 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 332 N Trade St, Ste 1500, Matthews, NC 281051728 | 7045126820 | |
| 6235 Blakeney Park Dr, Ste 100, Charlotte, NC 282775658 | 7045125060 | |
| 4501 Cameron Valley Pkwy, Ste 100, Charlotte, NC 282114297 | 7043677400 |
| Street Address |
13640 STEELECROFT PKWY STE 210 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28278-7565 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063444263 | Charles Bale | Obstetrics & Gynecology | 13640 Steelecroft Pkwy, Ste 240, Charlotte, NC 28278-7565 | 2006-07-07 |
| 1740711076 | John Licata | Pediatrics | 13640 Steelecroft Pkwy, Ste 210, Charlotte, NC 28278-7565 | 2017-03-27 |
| 1871038265 | Elissa Ann Bolling | Physician Assistant | 13640 Steelecroft Pkwy, Charlotte, NC 28278-7565 | 2016-12-21 |
| 1518339902 | Dustin Huerta | Nurse Practitioner | 13640 Steelecroft Pkwy, Charlotte, NC 28278-7565 | 2015-10-23 |
| 1316328818 | Shirin Jafari-namin | Pediatrics | 13640 Steelecroft Pkwy, Ste 210, Charlotte, NC 28278-7565 | 2015-06-11 |
| 1366847915 | Sana Umair | Hospitalist | 13640 Steelecroft Pkwy, Ste 320, Charlotte, NC 28278-7565 | 2014-10-24 |
| 1972924157 | Kathryn Alexis Repas | Physician Assistant | 13640 Steelecroft Pkwy, Charlotte, NC 28278-7565 | 2013-12-14 |
| 1023455425 | Colleen Pettrey | Internal Medicine | 13640 Steelecroft Pkwy, Ste 320, Charlotte, NC 28278-7565 | 2013-05-28 |
| 1801233390 | Courtney Moynihan | Obstetrics & Gynecology | 13640 Steelecroft Pkwy, Ste 240, Charlotte, NC 28278-7565 | 2013-05-24 |
| 1407299415 | Mitchell Alvarez | Obstetrics & Gynecology | 13640 Steelecroft Pkwy, Ste 240, Charlotte, NC 28278-7565 | 2013-04-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366060170 | Stride | Community/Behavioral Health | 14054 Singleleaf Lane, Charlotte, NC 28278 | 2020-07-08 |
| 1245742279 | Ruby Home Healthcare, LLC | Home Health | 17202 Belmont Stakes Lane, Charlotte, NC 28278 | 2017-10-31 |
| 1962926287 | Limitless Little Learners | Community/Behavioral Health | 13909 Derby Farm Lane, Charlotte, NC 28278 | 2017-07-28 |
| 1497106694 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 4821 Berewick Town Center Dr, Charlotte, NC 28278 | 2016-06-29 |
| 1932574753 | Adrienne Forney | Counselor | 14923 Alyssa Faith Court, Charlotte, NC 28278 | 2015-12-04 |
| 1447620398 | Sherae Threatt Lattimore | Behavioral Analyst | 5614 Samuel Neel Rd, Charlotte, NC 28278 | 2015-10-05 |
| 1528340676 | Khyati Dhaval Shah | Pediatrics | 13557 Steelecroft Pkwy Ste 2200, Charlotte, NC 28278 | 2011-09-14 |
| 1184915043 | John Angelo Tenini | Internal Medicine | 13557 Steelecroft Pkwy Ste 1200, Charlotte, NC 28278 | 2011-04-27 |
| 1568612240 | Kim Marie Briden | Contractor | 13805 Appling Lane, Charlotte, NC 28278 | 2008-09-30 |
| 1144477258 | Presbyterian Imaging Centers LLC | Radiology | 13557 Steelecroft Parkway, Suite 1100, Charlotte, NC 28278 | 2008-08-20 |
| Find all providers in zip 28278 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (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. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215544986 | Tonya Lynn Burris | Nurse Practitioner | 7810 Providence Rd Ste 102, Charlotte, NC 28226-2987 | 2020-09-28 |
| 1003428293 | Kashari Davis | Nurse Practitioner | 4252 Sutwick Dr, Charlotte, NC 28269-6001 | 2020-08-19 |
| 1457972796 | Lindsey O'brien | Nurse Practitioner | 3423 Hornets Nest Way, Charlotte, NC 28208-5224 | 2020-04-28 |
| 1285254904 | Barbara Ballard | Nurse Practitioner | 10731 Haddington Dr Nw, Charlotte, NC 28269-6954 | 2020-04-22 |
| 1710506787 | Lindsey Delcasino Plair | Nurse Practitioner | 1212 South Blvd, Charlotte, NC 28203-4215 | 2020-04-10 |
| 1457991275 | Advanced Physical Medicine | Nurse Practitioner | 8821 University East Dr # 120, Charlotte, NC 28213-4200 | 2020-01-09 |
| 1700447562 | Milford Darnell George Jr. | Nurse Practitioner | 8403 University Executive Park Drive, Suite 685, Charlotte, NC 28262-3330 | 2019-06-24 |
| 1194288241 | Tonya Denise Farmer | Nurse Practitioner | 620 Tom Hunter Road, Charlotte, NC 28213 | 2019-04-06 |
| 1649738204 | Brittany Schmalfeld | Nurse Practitioner | 8943 S Tryon St Unit K, Charlotte, NC 28273-3539 | 2019-03-03 |
| 1407313703 | Natalie Ann Bullock | Nurse Practitioner | 400 E Stonewall St Ste F, Charlotte, NC 28202-3601 | 2019-02-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.