Individual provider

Shannon Kimmel

Family Nurse Practitioner Medicare enrolled

Shannon Kimmel is a Family Nurse Practitioner in Charlotte, NC, registered under NPI 1104505890. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.

Getting there

The practice address on file is 9200 GLENWATER DR, Charlotte, NC 28262. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

9200 GLENWATER DR, Charlotte, NC 28262 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
5018442 NC Family Nurse Practitioner primary

This provider holds licence 5018442 issued in NC. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Nurse Practitioner
PAC ID
1052758851
Enrollment ID
I20240327003789

Medicare enrolment is recorded as approved under the provider type Practitioner - Nurse Practitioner. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

What Family covers

Definition to come... NUCC Health Care Provider Taxonomy, code 363LF0000X
Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1104505890 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateJul 12, 2023
Last updatedSep 26, 2025
StatusActive
Sole proprietorYes
Practice address 9200 GLENWATER DR
Charlotte, NC 28262
(901) 603-8704
Mailing address 6304 DURANGO WAY
Denver, NC 28037
This record was updated on Sep 26, 2025, which is recent enough that the contact details are likely still accurate.

Number check

1104505890 passes the NPI check digit test The final digit 0 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 1 0 4 5 0 5 8 9
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 1 0 4 1 0 1 8 9

Sum = 50 · next multiple of 10 = 50 · check digit = 0 · actual last digit = 0

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1104505890?
NPI 1104505890 is the National Provider Identifier assigned to Shannon Kimmel in Charlotte, NC. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Family cover?
Definition to come...
How do I contact Shannon Kimmel?
The phone number on file with NPPES is (901) 603-8704, last updated Sep 26, 2025. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Shannon Kimmel accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1104505890 a valid number?
Yes. 1104505890 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.