BARBARA ELIZABETH KISSAM (NPI# 1881689362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1881689362 |
Entity Type | Individual |
Full Name | BARBARA ELIZABETH KISSAM |
Credential | MD |
Practice Address |
1900 Randolph Rd Suite 1010 Charlotte NC 28207-1122 |
Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
Practice Telephone | 7043161155 |
Practice Fax Number | 7043161160 |
Mailing Telephone | 7043847840 |
Mailing Fax Number | 7043847830 |
Enumeration Date | 2005-09-12 |
Last Update Date | 2013-03-15 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2080P0006X |
Pediatrics Specialization: Developmental – Behavioral Pediatrics |
2006-01118 | NC | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | 32568300 | 05 |
Street Address |
1900 RANDOLPH RD SUITE 1010 |
City | CHARLOTTE |
State | NC |
Zip Code | 28207-1122 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144769332 | Courtney Wiseman | Physician Assistant | 1900 Randolph Rd, Suite 800, Charlotte, NC 28207-1122 | 2017-02-21 |
1700339785 | Yu Wei Shan | Nurse Practitioner | 1900 Randolph Rd, Suite 800, Charlotte, NC 28207-1122 | 2016-07-26 |
1891182127 | Novant Medical Group,inc | Pediatrics | 1900 Randolph Rd, Suite 300, Charlotte, NC 28207-1122 | 2015-04-24 |
1578979936 | Kristen Elizabeth Bush | Physician Assistant | 1900 Randolph Rd, Ste 900, Charlotte, NC 28207-1122 | 2014-07-07 |
1003235524 | Novant Medical Group Inc | Internal Medicine | 1900 Randolph Rd, Suite 216, Charlotte, NC 28207-1122 | 2014-04-11 |
1508107863 | Novant Medical Group Inc | Internal Medicine | 1900 Randolph Rd, Suite 300, Charlotte, NC 28207-1106 | 2013-03-12 |
1639422264 | Anthony James Mignanelli II | Nurse Practitioner | 1900 Randolph Rd, Suite 900, Charlotte, NC 28207-1122 | 2012-10-19 |
1851642169 | Meagan Marie Bullock | Social Worker | 1900 Randolph Rd, Suite 800, Charlotte, NC 28207-1122 | 2012-09-26 |
1114299294 | Worley Shaun Lynch | Physician Assistant | 1900 Randolph Rd, Suite 900, Charlotte, NC 28207-1122 | 2012-02-03 |
1124335427 | Ppg Pathology and Diagnostics Pllc | Clinical Medical Laboratory | 1900 Randolph Rd, Suite 708, Charlotte, NC 28207-1122 | 2010-09-08 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013560739 | Louis Roncaglione | Dentist | 8815 Christenbury Pkway, Concord, NC 28207 | 2019-07-22 |
1619430014 | Khrystyna Levytska | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Ob/gyn, 1350 S. Kings Dr., Charlotte, NC 28207 | 2019-04-11 |
1649743584 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 1005 South Kings Drive, Charlotte, NC 28207 | 2019-01-03 |
1023584489 | Herron and Smith Associates, Pllc | Dentist | 135 Perrin Place, Suite 100, Charlotte, NC 28207 | 2018-10-23 |
1588161640 | Lauren Mogk | Student in an Organized Health Care Education/Training Program | Myers Park Clinical Internal Medicine, 1350 S. Kings Dr., 3rd Floor, Charlotte, NC 28207 | 2018-04-06 |
1518462241 | Sarah Hollyn Carlock | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Internal Medicine, 1350 S Kings Dr, 3rd Floor, Charlotte, NC 28207 | 2018-03-26 |
1083118178 | Claire Milam | Student in an Organized Health Care Education/Training Program | Cmc/department of Emergency Medicine, 100 Blythe Blvd, Charlotte, NC 28207 | 2018-03-22 |
1811422256 | Complete Care At Dartmouth LLC | Skilled Nursing Facility | 300 Province Road, Charlotte, NC 28207 | 2017-04-24 |
1063945467 | Kaitlyn O'keefe | Internal Medicine | 1350 S. Kings Dr., 3rd Floor, Myers Park Clinic Internal Medicine, Charlotte, NC 28207 | 2017-04-04 |
1811432024 | Advanced Prosthetics of Easley, Inc | Durable Medical Equipment & Medical Supplies | 2310 Randolph Rd Ste A, Charlotte, NC 28207 | 2016-12-23 |
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Taxonomy Code | 2080P0006X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
Specialization | Developmental – Behavioral Pediatrics |
A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed, 3/26/2008: definition corrected] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801343793 | Novant Medical Group, Inc | Pediatrics | 1718 E 4th St, Suite 601, Charlotte, NC 28204-3261 | 2016-09-08 |
1942637319 | The Charlotte-mecklenburg Hospital Authority | Pediatrics | 2608 E 7th St, Suite B, Charlotte, NC 28204-4375 | 2013-10-01 |
1104162932 | Novant Medical Group, Inc | Pediatrics | 6331 Carmel Rd Ste 102, Charlotte, NC 28226 | 2012-12-26 |
1144580754 | Carolinas Medical Center-northeast | Pediatrics | 4501 Cameron Valley Pkwy, Suite 301-b, Charlotte, NC 28211-4297 | 2012-05-17 |
1306987185 | Yasmin Senturias | Pediatrics | 2608 E 7th St, Suite B, Charlotte, NC 28204-4375 | 2007-02-12 |
1275627812 | Tsehaiwork Fenikile | Pediatrics | 2608 E 7th St, Suite B, Charlotte, NC 28204-4375 | 2006-10-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548746365 | Kassondra Amada Shoemaker Brino | Pediatrics | 307 S Salem St Ste 100, Apex, NC 27502-1845 | 2018-07-15 |
1164949814 | Moses Cone Physician Services, Inc. | Pediatrics | 301 E Wendover Ave Ste 311, Greensboro, NC 27401-1210 | 2017-08-24 |
1821474628 | Melissa Thingvoll Md Pllc | Pediatrics | 7 Yorkshire St Ste 101, Asheville, NC 28803-2798 | 2015-08-04 |
1053445130 | Barbara Nan Samuels | Pediatrics | 108 W Fire Tower Rd Ste B, Ecu Pediatrics Autism Center, Winterville, NC 28590-8408 | 2007-03-14 |
1396823498 | Patricia Dockery Weavil | Pediatrics | 4805 Seward Rd, Pfafftown, NC 27040-9450 | 2006-11-02 |
1780782805 | Jean Charlotte Smith | Pediatrics | 10 Sunnybrook Road, Wake County Human Services, Raleigh, NC 27610-1808 | 2006-09-20 |
1528060209 | Arne John Anderson | Pediatrics | 108 W Fire Tower Rd, Winterville, NC 28590-8371 | 2005-08-12 |
1104479708 | Novant Medical Group Inc | Pediatrics | 311 Coddle Market Dr Nw Ste 200, Concord, NC 28027-2432 | 2019-07-23 |
1508426370 | Novant Medical Group Inc | Pediatrics | 17810 Statesville Rd Ste 311, Cornelius, NC 28031-8149 | 2019-06-14 |
1659934511 | Wake Specialty Physicians, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-04-17 |
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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.