Individual provider Active NPI

Nicole A. Cagle Richardson, MD

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1013065507
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2011-01311 Issued in NC
Practice address
1001 Blythe Blvd
Medical Center Plaza Suite 200
Charlotte, NC 28203-5866
Phone
(704) 381-8840
NPI assigned
Jan 8, 2007
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 2011-01311 NC
Pediatrics Physician 208000000X 2011-01311 NC Primary

Addresses

Primary practice location

1001 Blythe Blvd
Medical Center Plaza Suite 200
Charlotte, NC 28203-5866

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

920 Church St N
Concord, NC 28025-2927
Phone (704) 403-3664

Other practice location 2

105 Yadkin St
Ste 303
Albemarle, NC 28001-3449
Phone (980) 323-5400

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address ncaglerichardson499864@CarolinasHealthcareSystem.direct-ci.com Atrium Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090327000420 SC Practitioner - Pediatric MedicinePractitioner - Internal Medicine 4082771571 Reassigns benefits to 2 organizations
I20140916002145 NC Practitioner - Pediatric Medicine 4082771571 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2011-01311NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Hospitalist Services PC Hospitalist CurrentSince Jul 11, 2024 Accepting new patients
Carolina Family Care, Inc Pediatrics CurrentSince Nov 14, 2019 Accepting new patients
Carolina Family Care, Inc Pediatrics CurrentSince Nov 14, 2019 Accepting new patients
Carolinas Medical Center Pediatrics Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Aug 27, 2016 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Medical Center Pediatrics CurrentSince Aug 4, 2014 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Aug 27, 2016 Accepting new patients
Carolinas Medical Center CurrentSince Aug 4, 2014 Accepting new patients
Coastal Inpatient Physicians, LLC Past Accepting new patients
Walterboro Community Hospital, Inc. Past Accepting new patients
Lancaster Clinic Corp Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

105 Yadkin St
Ste 203
Albemarle, NC 28001
Phone (704) 403-2760

105 Yadkin St
Ste 303
Albemarle, NC 28001
Phone (704) 982-2683

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1001 Blythe Blvd
Ste 200
Charlotte, NC 28203
Phone (704) 373-0544

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

800 W Meeting St
Lancaster, SC 29720
Phone (803) 286-1214

1341 Old Georgetown Rd
Ste C
Mt Pleasant, SC 29464
Phone (843) 884-2175

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

9330 Medical Plaza Dr
North Charleston, SC 29406
Phone (843) 554-6366

501 Robertson Blvd
Walterboro, SC 29488
Phone (843) 549-2000

Interoperability endpoints

  • Direct secure messaging: ncaglerichardson285862@direct.musc.edu
  • Direct secure messaging: ncaglerichardson499864@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 12

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1013065507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BLYTHE BLVD",
            "address_2": "MEDICAL CENTER PLAZA SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035866",
            "telephone_number": "704-381-8840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Church St N",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252927",
            "country_code": "US",
            "telephone_number": "704-403-3664",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 Yadkin St",
            "address_2": "Ste 303",
            "address_purpose": "LOCATION",
            "city": "Albemarle",
            "state": "NC",
            "postal_code": "280013449",
            "country_code": "US",
            "telephone_number": "980-323-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAGLE RICHARDSON",
        "first_name": "NICOLE",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2024-07-15",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2011-01311",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2011-01311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ncaglerichardson499864@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1001 Blythe Blvd",
            "address_2": "Medical Center Plaza, Suite 200",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282035866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.