NPIMap

Organization Active NPI

Celeste Brain Health PLLC

Doing business as Celeste Neurology

  • Neurology Physician
  • Charlotte, NC
National Provider Identifier
1013642776
Registry record updated Dec 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
CELESTE BRAIN HEALTH PLLC
Doing business as
Celeste Neurology
Practice address
5500 Executive Center Dr Ste 206
Charlotte, NC 28212-8864
Phone
(984) 777-9940
Fax
(877) 794-5929
NPI assigned
Jul 18, 2022
Last updated
Dec 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2023

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

Authorized official

Name
Sumul ModiNPI 1033466776
Title
Owner/Partner
Phone
(984) 777-9940

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X NU Primary

Addresses

Primary practice location

5500 Executive Center Dr Ste 206
Charlotte, NC 28212-8864

Mailing address

5500 Executive Center Dr Ste 206
Charlotte, NC 28212-8864
Phone (984) 777-9940

Other names 1

  • Celeste Neurology Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sumul.modi@org78.direct.charmhealth.com Direct

National Provider Directory

National Provider Directory

Locations

5500 Executive Center Dr
Ste 206
Charlotte, NC 28212
Phone (336) 223-5065

Interoperability endpoints

  • Direct secure messaging: sumul.modi@org78.direct.charmhealth.com

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701475200000",
    "number": "1013642776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 EXECUTIVE CENTER DR STE 206",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128864",
            "telephone_number": "984-777-9940",
            "fax_number": "877-794-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 EXECUTIVE CENTER DR STE 206",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128864",
            "telephone_number": "984-777-9940",
            "fax_number": "877-794-5929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CELESTE BRAIN HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-18",
        "last_updated": "2023-12-02",
        "certification_date": "2023-12-02",
        "status": "A",
        "authorized_official_last_name": "MODI",
        "authorized_official_first_name": "SUMUL",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "984-777-9940"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sumul.modi@org78.direct.charmhealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct secure message HIPAA compliant",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5500 Executive Center Dr Ste 206",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282128864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Celeste Neurology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Celeste Neurology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.