Individual provider Active NPI

Charles Stuart Forbes Jr., PA

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1063722957
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-02582 Issued in NC
Practice address
3545 Whitehall Park Dr Ste 300
Charlotte, NC 28273-4179
Phone
(980) 302-8850
Fax
(704) 316-8118
NPI assigned
Oct 14, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-02582 NC Primary

Addresses

Primary practice location

3545 Whitehall Park Dr Ste 300
Charlotte, NC 28273-4179

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

175 Kimel Park Dr Ste 100
Winston Salem, NC 27103-6951
Phone (336) 718-3550

Other practice location 2

321 Mulberry St SW
Lenoir, NC 28645-5720
Phone (828) 394-6722

Other practice location 3

501 Billingsley Rd
Ste B
Charlotte, NC 28211-1009
Phone (704) 444-2400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cforbes526666@direct.novanthealth.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110103000189 NC Practitioner - Physician Assistant 1355539552 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Drake University College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3515 Whitehall Park Dr
Suite 300
Charlotte, NC 28273-4179

3545 Whitehall Park Dr
Suite 300
Charlotte, NC 28273-4179
Phone (980) 302-8850

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
027696NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center CurrentSince Jul 13, 2020 Accepting new patients
Carolinas Medical Center CurrentSince Jul 13, 2020 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 1, 2022 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

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

501 Billingsley Rd
Ste B
Charlotte, NC 28211
Phone (704) 444-2400

Interoperability endpoints

  • Direct secure messaging: cforbes526666@direct.novanthealth.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1063722957",
    "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": "3545 WHITEHALL PARK DR STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282734179",
            "telephone_number": "980-302-8850",
            "fax_number": "704-316-8118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Kimel Park Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271036951",
            "country_code": "US",
            "telephone_number": "336-718-3550",
            "fax_number": "336-277-1825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "321 Mulberry St SW",
            "address_purpose": "LOCATION",
            "city": "Lenoir",
            "state": "NC",
            "postal_code": "286455720",
            "country_code": "US",
            "telephone_number": "828-394-6722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Billingsley Rd",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282111009",
            "country_code": "US",
            "telephone_number": "704-444-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORBES",
        "first_name": "CHARLES",
        "middle_name": "STUART",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-14",
        "last_updated": "2022-04-19",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-02582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cforbes526666@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "175 Kimel Park Dr Ste 100",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271036951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.