Individual provider Active NPI

Kathy Garland Mohanty, MD

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1003835398
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
200100746 Issued in NC
Practice address
6324 Fairview Rd Ste 350
Charlotte, NC 28210-0095
Phone
(704) 384-8600
Fax
(704) 384-8610
NPI assigned
Jul 18, 2006
Last updated
Nov 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 200100746 NC Primary

Addresses

Primary practice location

6324 Fairview Rd Ste 350
Charlotte, NC 28210-0095

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-7840

Other identifiers 3

IdentifierTypeStateIssuer
89129NCMedicaidNC
N0074CMedicaidSC
129NCOtherNCBCBS PROVIDER #

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmohanty14600@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211118003031 NC Practitioner - Pediatric Medicine 8527311901 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Oct 21, 2021 Accepting new patients
Novant Medical Group, Inc. CurrentSince Oct 21, 2021 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

6324 Fairview Rd
Ste 350
Charlotte, NC 28210
Phone (704) 384-8600

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1003835398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-7840",
            "fax_number": "704-384-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6324 FAIRVIEW RD STE 350",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282100095",
            "telephone_number": "704-384-8600",
            "fax_number": "704-384-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHANTY",
        "first_name": "KATHY",
        "middle_name": "GARLAND",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200100746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89129NC",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N0074C",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "129NC",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmohanty14600@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "6324 Fairview Rd Ste 350",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282100095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.