Individual provider Active NPI

Edward Anthony Overton, D.O.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Charlotte, NC
National Provider Identifier
1093753329
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
200400934 Issued in NC
Practice address
2315 W Arbors Dr Ste 115
Charlotte, NC 28262-2639
Phone
(704) 817-6676
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X OS-010979L PA
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 1146 SC
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 53011 GA
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 200400934 NC Primary

Addresses

Primary practice location

2315 W Arbors Dr Ste 115
Charlotte, NC 28262-2639

Mailing address

PO Box 480328
Charlotte, NC 28269-5338
Phone (215) 669-9668

Other practice location 1

10310 Mallard Creek Rd
Ste 101-c
Charlotte, NC 28262-9771
Phone (215) 669-9668

Other identifiers 5

IdentifierTypeStateIssuer
2335844000OtherPAIBC
NC1316MedicaidSC
3686882OtherPAAETNA
5908315MedicaidNC
6738998OtherCIGNA

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
I20041005001149 NC Practitioner - Interventional Pain ManagementPractitioner - Physical Medicine and Rehabilitation 2163481219 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
Philadelphia College of Osteopathic Medicine, 1999
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians
Carolina Spine, Pain and Rehabilitation PLLCGroup PAC ID 7618949702, 3 clinicians

Practice addresses (Care Compare)

2315 W Arbors Dr
Suite 115
Charlotte, NC 28262-2639
Phone (704) 817-6676

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

900 Cox Rd
Suite a
Gastonia, NC 28054-3433
Phone (704) 864-3300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
53011GAMDPain Medicine (Physical Medicine & Rehabilitation) Physician
200400934NCMDPain Medicine (Physical Medicine & Rehabilitation) Physician
OS-010979LPAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Spine, Pain and Rehabilitation PLLC Pain Medicine CurrentSince Jul 8, 2004 Accepting new patients

Locations

900 Cox Rd
Ste A
Gastonia, NC 28054
Phone (704) 864-3300

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 3

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1093753329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 480328",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282695338",
            "telephone_number": "215-669-9668",
            "fax_number": "704-864-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 W ARBORS DR STE 115",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282622639",
            "telephone_number": "704-817-6676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10310 Mallard Creek Rd",
            "address_2": "Ste 101-c",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282629771",
            "country_code": "US",
            "telephone_number": "215-669-9668",
            "fax_number": "704-864-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OVERTON",
        "first_name": "EDWARD",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "PA",
            "license": "OS-010979L",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "SC",
            "license": "1146",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "GA",
            "license": "53011",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NC",
            "license": "200400934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "2335844000",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC1316",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3686882",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908315",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6738998",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.