NPIMap

Individual provider Active NPI

Jamalia Junelle David, MD

  • Family Medicine Physician
  • Monroe, NC
National Provider Identifier
1083930580
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
164504 Issued in NC
Practice address
1106 Reynolds St
Monroe, NC 28112-4375
Phone
(704) 226-5013
Fax
(704) 296-4172
NPI assigned
Apr 9, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 164504 NC Primary

Addresses

Primary practice location

1106 Reynolds St
Monroe, NC 28112-4375

Mailing address

1106 Reynolds St
Monroe, NC 28112-4375
Phone (704) 226-5013

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdavid41376@direct.novanthealth.org

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
I20131025001430 NC Practitioner - Family Practice 2264667369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

7903 Providence Rd
Suite 100
Charlotte, NC 28277-9763
Phone (704) 316-4460

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
164504NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 1, 2013 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 1, 2013 Accepting new patients

Locations

7903 Providence Rd
Ste 100
Charlotte, NC 28277
Phone (704) 316-4460

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

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

4105 Matthews Mint Hill Rd
Matthews, NC 28105
Phone (704) 316-3095

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

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

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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": "1270771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1083930580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 REYNOLDS ST",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281124375",
            "telephone_number": "704-226-5013",
            "fax_number": "704-296-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 REYNOLDS ST",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281124375",
            "telephone_number": "704-226-5013",
            "fax_number": "704-296-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVID",
        "first_name": "JAMALIA",
        "middle_name": "JUNELLE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-09",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "164504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdavid41376@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1106 Reynolds St",
            "city": "Monroe",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281124375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

Verify at the official NPI Registry.