NPIMap

Individual provider Active NPI

Sheryl Maria Savita De Sa

  • Family Medicine Physician
  • Concord, NC
National Provider Identifier
1083121776
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2024-02510 Issued in NC
Practice address
5325 Vinning St NW Ste 101
Concord, NC 28027-2956
Phone
(704) 316-1040
Fax
(704) 316-1041
NPI assigned
Jan 4, 2018
Last updated
Sep 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 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 MD471281 PA
Family Medicine Physician 207Q00000X 2024-02510 NC Primary

Addresses

Primary practice location

5325 Vinning St NW Ste 101
Concord, NC 28027-2956

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

1100 Million Dollar Hwy
Saint Marys, PA 15857-2728
Phone (814) 781-6758

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
I20241102000230 NC Practitioner - Family Practice 3072923580 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
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)

13460 Plaza Rd Ext
Suite 100
Charlotte, NC 28215-8923
Phone (704) 316-4990

5325 Vinning NWST
Suite 101
Concord, NC 28027-2956
Phone (704) 316-1040

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024-02510NCMDFamily Medicine Physician
MD471281PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Multi-Specialty CurrentSince Sep 7, 2024 Accepting new patients
Novant Health Medical Group, LLC Multi-Specialty CurrentSince Sep 7, 2024 Accepting new patients
Novant Health Medical Group, LLC Multi-Specialty Current Accepting new patients
Novant Health Medical Group, LLC Multi-Specialty CurrentSince Sep 7, 2024 Accepting new patients
Novant Medical Group, Inc. Multi-Specialty Current Accepting new patients
Novant Health Medical Group, LLC Multi-Specialty Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

200 Greenwich Rd
Charlotte, NC 28211
Phone (704) 384-8680

5325 Vinning St NW
Ste 101
Concord, NC 28027
Phone (704) 316-1040

7752 Gateway Ln NW
Ste 100
Concord, NC 28027
Phone (704) 316-4950

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

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

Interoperability endpoints

  • Direct secure messaging: sdesa1611575@direct.novanthealth.org

Organizations & group practices 7

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": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1083121776",
    "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": "5325 VINNING ST NW STE 101",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280272956",
            "telephone_number": "704-316-1040",
            "fax_number": "704-316-1041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Million Dollar Hwy",
            "address_purpose": "LOCATION",
            "city": "Saint Marys",
            "state": "PA",
            "postal_code": "158572728",
            "country_code": "US",
            "telephone_number": "814-781-6758",
            "fax_number": "814-834-1038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE SA",
        "first_name": "SHERYL",
        "middle_name": "MARIA SAVITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-04",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD471281",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2024-02510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.