Individual provider Active NPI

Nadia Mohamad Nasser

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1013366699
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2021-03225 Issued in NC
Practice address
1918 Randolph Rd Ste 350
Charlotte, NC 28207-1111
Phone
(704) 384-1750
Fax
(704) 384-1720
NPI assigned
Jun 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 2021-03225 NC Primary

Addresses

Primary practice location

1918 Randolph Rd Ste 350
Charlotte, NC 28207-1111

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

653 Bluefield Road, Ste F
Mooresville, NC 28117
Phone (704) 360-6480

Other practice location 2

4201 St. Antoine St
9C-Uhc
Detroit, MI 48201
Phone (313) 745-5146

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
I20211221002465 NC Practitioner - Internal Medicine 9830480631

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021-03225NCMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: nnasser1080467@direct.novanthealth.org

NPI Registry JSON

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1013366699",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 RANDOLPH RD STE 350",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071111",
            "telephone_number": "704-384-1750",
            "fax_number": "704-384-1720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "653 Bluefield Road, Ste F",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "28117",
            "country_code": "US",
            "telephone_number": "704-360-6480",
            "fax_number": "704-883-3228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4201 St. Antoine St",
            "address_2": "9C-UHC",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "48201",
            "country_code": "US",
            "telephone_number": "313-745-5146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NASSER",
        "first_name": "NADIA",
        "middle_name": "MOHAMAD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2021-03225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.