David Earl Small Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

183546 Issued in NC

Practice address

5815 Blakeney Park Dr
Suite 200
Charlotte, NC 28277-5731

Phone

(704) 316-5080

Fax

(704) 316-5085

NPI assigned

Jun 5, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Family Practice

Education

Brody School of Medicine at East Carolina University, 2011

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)

Hospital & facility affiliations

• Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
• Novant Health Ballantyne Medical Center Hospital, Charlotte, NC, CCN 340195

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Edward M. Kennedy Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Worcester, MA
  • NPI 1609842152

  Corporate Director, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

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.

• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group NPD
• Novant Health Medical Group, LLC

  dba NHMG Primary Care Clinics

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Edward M. Kennedy Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Worcester, MA
  • NPI 1316324650
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Novant Health Ballantyne Medical Center LLC

  dba Novant Health Ballantyne Medical Center

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1740998020
  Care Compare affiliation
• Novant Health Matthews Medical Center LLC

  dba Novant Health Matthews Medical Center

  • General Acute Care Hospital
  • Matthews, NC
  • NPI 1063463156
  Care Compare affiliation

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1093076184",
    "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",
            "telephone_number": "704-316-5080",
            "fax_number": "704-316-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5815 BLAKENEY PARK DR",
            "address_2": "SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282775731",
            "telephone_number": "704-316-5080",
            "fax_number": "704-316-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "DAVID",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-05",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "183546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dsmall244086@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "5815 Blakeney Park Dr",
            "address_2": "Suite 200",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282775731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• SM Counseling Services PLLC
• Small Space Therapist PLLC
• Small Speakers, PLLC
• Small Talk Pediatric Speech Therapy PLLC
• Cassidy Small
• Donte Small
• Jacqueline M Small, PT
• Stacey Small, LMBT
• Stephen Andrew Small, M.D.
• Jennifer Lynn Smalley Adqui, FNP

• Family Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.