MEDICARE: KIMBERLY CUMMINGS PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	1538845565	NC

General Provider Information

NPI Number	:	1538845565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY CUMMINGS PA-C

Provider Business Mailing Address
First Line	:	7314 WAVERLY WALK AVE
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-4845
Country	:	US
Telephone Number	:	704-324-6863
Fax Number	:

Provider Business Practice Location Address
First Line	:	7314 WAVERLY WALK AVE UNIT E7
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-4846
Country	:	US
Telephone Number	:	704-324-6863
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2023
Last Update Date	:	02/10/2026

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Directions to “ KIMBERLY CUMMINGS PA-C” Practice Location

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