Individual provider Active NPI

Nicole Schaefer, FNP

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1073666004
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5005405 Issued in NC
Practice address
1025 Morehead Medical Dr
Ste 300
Charlotte, NC 28204-2963
Phone
(704) 355-4593
NPI assigned
Jan 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 216380 SC
Nurse Practitioner 363L00000X 5005405 NC Primary

Addresses

Primary practice location

1025 Morehead Medical Dr
Ste 300
Charlotte, NC 28204-2963

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1585 Forney Creek Pkwy
Ste 2350
Denver, NC 28037-9514
Phone (980) 212-4000

Other practice location 2

10502 Park Rd
Ste 150
Charlotte, NC 28210-8479
Phone (704) 667-0520

Other practice location 3

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-1255

Other practice location 4

441 McAlister Rd
Lincolnton, NC 28092-4126
Phone (980) 212-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
216380SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients

Locations

1025 Morehead Medical Dr
Fl 3
Charlotte, NC 28204
Phone (704) 355-4593

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

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

1025 Morehead Medical Dr
Ste 300
Charlotte, NC 28204
Phone (704) 355-1813

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

16455 Statesville Rd
Ste 360
Huntersville, NC 28078
Phone (704) 801-3300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1073666004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MOREHEAD MEDICAL DR",
            "address_2": "STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042963",
            "telephone_number": "704-355-4593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1585 Forney Creek Pkwy",
            "address_2": "Ste 2350",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "NC",
            "postal_code": "280379514",
            "country_code": "US",
            "telephone_number": "980-212-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10502 Park Rd",
            "address_2": "STE 150",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108479",
            "country_code": "US",
            "telephone_number": "704-667-0520",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-1255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "441 McAlister Rd",
            "address_purpose": "LOCATION",
            "city": "Lincolnton",
            "state": "NC",
            "postal_code": "280924126",
            "country_code": "US",
            "telephone_number": "980-212-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "NICOLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-21",
        "last_updated": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "216380",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5005405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.