Individual provider Active NPI

Simon Vivian Ward III, M.D.

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
National Provider Identifier
1003878919
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
30970 Issued in NC
Practice address
1918 Randolph Rd
Suite 670
Charlotte, NC 28207-1100
Phone
(704) 384-1620
Fax
(704) 384-1626
NPI assigned
Apr 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 30970 NC Primary

Addresses

Primary practice location

1918 Randolph Rd
Suite 670
Charlotte, NC 28207-1100

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-1620

Other identifiers 1

IdentifierTypeStateIssuer
8985668MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sward14916@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
I20060327000134 NC Practitioner - Obstetrics/Gynecology 2961410428 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Louisiana State University School of Medicine in New Orleans, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

5933 Blakeney Park Dr
Suite 100
Charlotte, NC 28277-5713
Phone (704) 316-2021

911 W Henderson St
Suite 300
Salisbury, NC 28144-2700
Phone (704) 636-9270

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30970NCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Apr 1, 1996 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Obstetrics & Gynecology CurrentSince Jan 22, 2017 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

1718 E 4th St
Ste 201
Charlotte, NC 28204
Phone (704) 384-0560

5933 Blakeney Park Dr
Ste 100
Charlotte, NC 28277
Phone (704) 316-2021

9955 Poplar Tent Rd
Concord, NC 28027
Phone (704) 316-1161

9930 Kincey Ave
Ste 360
Huntersville, NC 28078

14330 Oakhill Park Ln
Ste 200
Huntersville, NC 28078
Phone (704) 316-1265

911 W Henderson St
Ste 300
Salisbury, NC 28144
Phone (704) 636-9270

Networks

  • TN PPO
  • TN PPO C-SNP
  • devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
  • devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
  • devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

Interoperability endpoints

  • Direct secure messaging: sward14916@direct.novanthealth.org

Organizations & group practices 5

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1003878919",
    "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": "704-384-1620",
            "fax_number": "704-384-1626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 RANDOLPH RD",
            "address_2": "SUITE 670",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071100",
            "telephone_number": "704-384-1620",
            "fax_number": "704-384-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "SIMON",
        "middle_name": "VIVIAN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "30970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8985668",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sward14916@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1918 Randolph Rd",
            "address_2": "Suite 670",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282071100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.