Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelli Anne Wall

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1639760945

Kelli Anne Wall is a Physician Assistant in Charlotte, North Carolina. Qualified in 2021, 5 years ago. Practices with Novant Health Medical Group, LLC, a 2,410-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in North Carolina.

Years since qualifying
5
Licensed in
NC
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Charlotte, NC

No coordinates on file. Search this address in Google Maps

Additional practice locations (2)

  • 14837 Cane Field Dr, Charlotte, NC 28273-8848 — (352) 942-4010
  • 1450 Matthews Township Pkwy Ste 450, Matthews, NC 28105-5343 — (704) 384-8480

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-11928 (NC)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1639760945
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 29, 2021
Last updated in NPPESNovember 14, 2025
Certification dateNovember 14, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Novant Health Medical Group, Llc — 2410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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