NPIMap

Individual provider Active NPI

Gerald William Bennett Jr.

  • Hospitalist Physician
  • Charlotte, NC
National Provider Identifier
1053762179
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2023-03354 Issued in NC
Practice address
10905 Providence Rd W, Ste G200
Charlotte, NC 28277-1538
Phone
(980) 488-4900
Fax
(980) 488-4905
NPI assigned
Jun 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LL39578 SC
Hospitalist Physician 208M00000X 2023-03354 NC Primary

Addresses

Primary practice location

10905 Providence Rd W, Ste G200
Charlotte, NC 28277-1538

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (980) 488-4900

Other practice location 1

853 N Church St Ste 510
Spartanburg, SC 29303-3077
Phone (864) 560-6193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190909003379 SC Practitioner - Family Practice 3870881469 Reassigns benefits to 1 organization
I20240408000296 NC Practitioner - HospitalistPractitioner - Family Practice 3870881469 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

600 Hospital Dr
Monroe, NC 28112-6000
Phone (704) 283-3100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023-03354NCMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince May 19, 2025 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince May 19, 2025 Accepting new patients
Southeastern Hospitalist Services PC Family Medicine CurrentSince Aug 1, 2019 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince May 19, 2025 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Hospitalist CurrentSince May 19, 2025 Accepting new patients

Locations

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

433 McAlister Rd
Lincolnton, NC 28092
Phone (704) 512-7000

600 Hospital Dr
Monroe, NC 28112
Phone (704) 283-3100

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

Interoperability endpoints

  • Direct secure messaging: gbennett3003294@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 8

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": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1053762179",
    "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",
            "telephone_number": "980-488-4900",
            "fax_number": "980-488-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10905 PROVIDENCE RD W, STE G200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282771538",
            "telephone_number": "980-488-4900",
            "fax_number": "980-488-4905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "853 N Church St Ste 510",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293033077",
            "country_code": "US",
            "telephone_number": "864-560-6193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "GERALD",
        "middle_name": "WILLIAM",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-30",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL39578",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2023-03354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.