NPIMap

Individual provider Active NPI

Mona Walid Shaban, MD

  • Nephrology Physician
  • Concord, NC
National Provider Identifier
1053758714
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
2016-01797 Issued in NC
Practice address
433 Copperfield Blvd NE
Concord, NC 28025-2405
Phone
(704) 786-7770
NPI assigned
Jun 4, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 2016-01797 NC Primary

Addresses

Primary practice location

433 Copperfield Blvd NE
Concord, NC 28025-2405

Mailing address

3158 Freedom Dr Ste 31023158
Charlotte, NC 28208-3876
Phone (704) 719-7099

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mshaban66473@direct.acumenmd.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180507002762 NC Practitioner - NephrologyPractitioner - Internal Medicine 8921226770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metrolina Nephrology Associates PAGroup PAC ID 8022916600, 85 clinicians

Practice addresses (Care Compare)

433 Copperfield Blvd NE
Concord, NC 28025-2405
Phone (704) 786-7770

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016-01797NCMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metrolina Nephrology Associates, PA Nephrology CurrentSince Jul 30, 2018 Accepting new patients

Locations

2711 Randolph Rd
Ste 400
Charlotte, NC 28207
Phone (704) 342-1900

3158 Freedom Dr
Ste 3102
Charlotte, NC 28208
Phone (704) 731-6857

1300 Baxter St
Ste 215
Charlotte, NC 28204

433 Copperfield Blvd NE
Concord, NC 28025
Phone (704) 786-7770

2544 Court Dr
Ste F
Gastonia, NC 28054
Phone (704) 864-8302

Organizations & group practices 1

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1053758714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3158 FREEDOM DR STE 31023158",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282083876",
            "telephone_number": "704-719-7099",
            "fax_number": "704-971-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 COPPERFIELD BLVD NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252405",
            "telephone_number": "704-786-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABAN",
        "first_name": "MONA",
        "middle_name": "WALID",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-04",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NC",
            "license": "2016-01797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mshaban66473@direct.acumenmd.com",
            "affiliation": "N",
            "endpointDescription": "Acumen Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CED",
            "address_1": "433 Copperfield Blvd NE",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.