Individual provider Active NPI

Emily Ann Eckerson, PA

  • Physician Assistant
  • Concord, NC
National Provider Identifier
1093282113
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-08407 Issued in NC
Practice address
315 Medical Park Dr
Ste 202
Concord, NC 28025-1902
Phone
(704) 403-1911
NPI assigned
Oct 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-08407 NC Primary

Addresses

Primary practice location

315 Medical Park Dr
Ste 202
Concord, NC 28025-1902

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

441 McAlister Rd
Ste 2200
Lincolnton, NC 28092-4126
Phone (980) 212-6652

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address eeckerson622937@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220104000517 NC Practitioner - Physician Assistant 9931444148 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Charlotte-Mecklenburg Hospital AuthorityGroup PAC ID 2961310685, 594 clinicians

Practice addresses (Care Compare)

1085 NE Gateway CT NE
Suite 290
Concord, NC 28025-2412
Phone (704) 403-4650

200 Medical Park Dr
Concord, NC 28025-0933

315 Medical Park Dr
Suite 202
Concord, NC 28025-2973
Phone (704) 403-1911

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
022856NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Oct 7, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 27, 2021 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Oct 7, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 27, 2021 Accepting new patients
Community Care Physicians, PC Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

5435 Prosperity Church Rd
Ste 2200
Charlotte, NC 28269
Phone (704) 863-9830

5727 Prosperity Crossing Dr
Ste 2200
Charlotte, NC 28269
Phone (704) 618-7894

315 Medical Park Dr
Ste 202
Concord, NC 28025
Phone (704) 262-1911

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

1085 NE Gateway Ct NE
#200A
Concord, NC 28025
Phone (704) 403-8650

441 McAlister Rd
Ste 2200
Lincolnton, NC 28092
Phone (980) 212-6230

Interoperability endpoints

  • Direct secure messaging: eeckerson622937@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 8

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": "1540512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1093282113",
    "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": "315 MEDICAL PARK DR",
            "address_2": "STE 202",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251902",
            "telephone_number": "704-403-1911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "441 McAlister Rd",
            "address_2": "Ste 2200",
            "address_purpose": "LOCATION",
            "city": "Lincolnton",
            "state": "NC",
            "postal_code": "280924126",
            "country_code": "US",
            "telephone_number": "980-212-6652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ECKERSON",
        "first_name": "EMILY",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-26",
        "last_updated": "2024-07-15",
        "certification_date": "2022-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eeckerson622937@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "315 Medical Park Dr",
            "address_2": "Ste 202",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280251902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.