Individual provider Active NPI

Paul Smolen

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1083628218
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
23762 Issued in NC
Practice address
14214 Ballantyne Lake Rd
Suite 300
Charlotte, NC 28277-3372
Phone
(704) 667-2600
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 23762 NC Primary

Addresses

Primary practice location

14214 Ballantyne Lake Rd
Suite 300
Charlotte, NC 28277-3372

Mailing address

14214 Ballantyne Lake Rd
Charlotte, NC 28277-3372

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190910001467 NC Practitioner - Pediatric Medicine 0345579793 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23762NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Apr 19, 2020 Accepting new patients
University Pediatrics Pediatrics CurrentSince Jun 24, 2019 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Apr 19, 2020 Accepting new patients
University Pediatrics Pediatrics CurrentSince Jun 24, 2019 Accepting new patients

Locations

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

4501 Cameron Valley Pkwy
Ste 200B
Charlotte, NC 28211
Phone (704) 381-0500

101 E Wt Harris Blvd
Ste 1121
Charlotte, NC 28262
Phone (704) 717-2000

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

Interoperability endpoints

  • Direct secure messaging: psmolen128809@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1083628218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14214 BALLANTYNE LAKE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14214 BALLANTYNE LAKE RD",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773372",
            "telephone_number": "704-667-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOLEN",
        "first_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "23762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.