Individual provider Active NPI

Michael Stephen Merrill, M.D.

  • Emergency Medicine Physician
  • Charlotte, NC
National Provider Identifier
1013208933
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2014-002007 Issued in NC
Practice address
501 S Sharon Amity Rd Ste 300
Charlotte, NC 28211
Phone
(704) 377-2424
Fax
(704) 377-2687
NPI assigned
Apr 26, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2014-002007 NC Primary

Addresses

Primary practice location

501 S Sharon Amity Rd Ste 300
Charlotte, NC 28211

Mailing address

501 S Sharon Amity Rd Ste 300
Charlotte, NC 28211-0035
Phone (704) 377-2424

Other practice location 1

FORSYTH MEDICAL CENTER -Emergency Room
3333 Silas Creek Pkway
Winston Salem, NC 27103-3013
Phone (800) 899-5757

Other practice location 2

FORSYTH MEDICAL CENTER -Emergency Room
3333 Silas Creek Pkway
Winston Salem, NC 27103-3013
Phone (800) 899-5757

Other practice location 3

KERNERSVILLE MEDICAL CENTER-Emergency Dept
1750 Kernersville Medical Pkwy
Kernersville, NC 27284-7146
Phone (314) 821-8055

Other practice location 4

CLEMMONS MEDICAL CENTER-Emergency Room
6915 Village Medical Circle
Clemmons, NC 27012-8002
Phone (800) 899-5757

Other practice location 5

1000 Blythe Blvd
Meb 3
Charlotte, NC 28203-5812
Phone (704) 355-3658

Other identifiers 2

IdentifierTypeStateIssuer
186BFOtherNCBCBS
1013208933MedicaidNC

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
I20140818002779 NC Practitioner - Emergency Medicine 1557588381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Wake Forest University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Atlantic Emergency Medical Associates PLLCGroup PAC ID 4880686823, 100 clinicians

Practice addresses (Care Compare)

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 377-2424

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.97 of 100Reported as group
Quality
79.68
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014-002007NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Atlantic Emergency Medical Associates, PLLC Emergency Medicine CurrentSince Sep 1, 2018 Accepting new patients
Mema SC LLC Emergency Medicine PastSince Oct 13, 2024 Accepting new patients

Locations

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

501 S Sharon Amity Rd
Ste 300
Charlotte, NC 28211
Phone (704) 319-5821

1500 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 384-6500

Organizations & group practices 2

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 5

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": "1303776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1013208933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S SHARON AMITY RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282110035",
            "telephone_number": "704-377-2424",
            "fax_number": "704-377-2687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S SHARON AMITY RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28211",
            "telephone_number": "704-377-2424",
            "fax_number": "704-377-2687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "FORSYTH MEDICAL CENTER -Emergency Room",
            "address_2": "3333 SILAS CREEK PKWAY",
            "address_purpose": "LOCATION",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "country_code": "US",
            "telephone_number": "800-899-5757",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "FORSYTH MEDICAL CENTER -Emergency Room",
            "address_2": "3333 SILAS CREEK PKWAY",
            "address_purpose": "LOCATION",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "country_code": "US",
            "telephone_number": "800-899-5757",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "KERNERSVILLE MEDICAL CENTER-Emergency Dept",
            "address_2": "1750 KERNERSVILLE MEDICAL PKWY",
            "address_purpose": "LOCATION",
            "city": "Kernersville",
            "state": "NC",
            "postal_code": "272847146",
            "country_code": "US",
            "telephone_number": "314-821-8055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "CLEMMONS MEDICAL CENTER-Emergency Room",
            "address_2": "6915 VILLAGE MEDICAL CIRCLE",
            "address_purpose": "LOCATION",
            "city": "Clemmons",
            "state": "NC",
            "postal_code": "270128002",
            "country_code": "US",
            "telephone_number": "800-899-5757",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Blythe Blvd",
            "address_2": "MEB 3",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035812",
            "country_code": "US",
            "telephone_number": "704-355-3658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERRILL",
        "first_name": "MICHAEL",
        "middle_name": "STEPHEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-26",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2014-002007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "186BF",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013208933",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.