Individual provider Active NPI

Heather Ann-Marie Chavis, LCSW

  • Clinical Social Worker
  • Huntersville, NC
National Provider Identifier
1023529294
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C012458 Issued in NC
Practice address
13815 Professional Center Dr Ste 100
Huntersville, NC 28078-7951
Phone
(704) 384-1320
Fax
(704) 316-3138
NPI assigned
Oct 16, 2017
Last updated
Jan 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C012458 NC Primary

Addresses

Primary practice location

13815 Professional Center Dr Ste 100
Huntersville, NC 28078-7951

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

990 Villa St
Mountain View, CA 94041-1236
Phone (704) 200-0685

Other practice location 2

200 Medical Park Dr # 550B
Concord, NC 28025-2982
Phone (704) 403-7664

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL other Direct
Other URL other Health Information Exchange (HIE)

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231016001528 NC Practitioner - Clinical Social Worker 7719332451 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

13815 Professional Ctr Dr
Suite 100
Huntersville, NC 28078-7951
Phone (704) 384-1320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C012458NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Sep 13, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Dec 8, 2023 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Dec 8, 2023 Accepting new patients

Locations

1900 Randolph Rd
Ste 800
Charlotte, NC 28207
Phone (704) 941-4171

6324 Fairview Rd
Ste 460
Charlotte, NC 28210
Phone (980) 302-8611

3511 Shannon Rd
Fl 3
Durham, NC 27707
Phone (201) 293-7689

13815 Professional Center Dr
Ste 100
Huntersville, NC 28078
Phone (704) 316-2050

1401 Matthews Township Pkwy
Ste 320
Matthews, NC 28105
Phone (704) 316-9064

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Networks

  • devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

Interoperability endpoints

  • Direct secure messaging: hchavis1238414@direct.novanthealth.org

Organizations & group practices 4

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": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1023529294",
    "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": "13815 PROFESSIONAL CENTER DR STE 100",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787951",
            "telephone_number": "704-384-1320",
            "fax_number": "704-316-3138"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "990 Villa St",
            "address_purpose": "LOCATION",
            "city": "Mountain View",
            "state": "CA",
            "postal_code": "940411236",
            "country_code": "US",
            "telephone_number": "704-200-0685",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Medical Park Dr # 550B",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252982",
            "country_code": "US",
            "telephone_number": "704-403-7664",
            "fax_number": "704-403-9178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAVIS",
        "first_name": "HEATHER",
        "middle_name": "ANN-MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-16",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C012458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "other",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "200 Medical Park Dr # 550B",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252982",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "other",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "990 Villa St",
            "city": "Mountain View",
            "state": "CA",
            "country_code": "US",
            "postal_code": "940411236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

Verify at the official NPI Registry.