Individual provider Active NPI

Jasper C Ratterree III, M.D.

  • Emergency Medicine Physician
  • Charlotte, NC
National Provider Identifier
1093769754
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
38175 Issued in NC
Practice address
1900 Randolph Rd
Ste 900
Charlotte, NC 28207-1106
Phone
(704) 377-2424
Fax
(704) 377-2687
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 38175 NC Primary

Addresses

Primary practice location

1900 Randolph Rd
Ste 900
Charlotte, NC 28207-1106

Mailing address

501 S Sharon Amity Rd
Ste 300
Charlotte, NC 28211-0035
Phone (704) 377-2424

Other identifiers 4

IdentifierTypeStateIssuer
70506OtherNCBCBSNC
89-70506MedicaidNC
930067618OtherNCRR MEDICARE
N38175MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050106000113 NC Practitioner - Emergency Medicine 6305894361 Reassigns benefits to 2 organizations
I20110222000324 SC Practitioner - Emergency Medicine 6305894361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Vanderbilt University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Atlantic Emergency Medical Associates PLLCGroup PAC ID 4880686823, 100 clinicians
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

10905 Providence Rd W
Charlotte, NC 28277-1538
Phone (980) 488-1200

1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone (704) 384-6500

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 377-2424

222 S Herlong Ave
Rock Hill, SC 29732-1158
Phone (803) 329-1234

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.97 of 100Reported as group
Quality
79.68
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38175NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Mar 1, 2016 Accepting new patients
Mid-Atlantic Emergency Medical Associates, PLLC Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients
Gastonia Physician Services, PLLC Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients
Mema SC LLC Emergency Medicine CurrentSince Oct 13, 2024 Accepting new patients
Gastonia Physician Services, PLLC Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients
South Carolina Emergency Physicians, LLC Emergency Medicine Past Accepting new patients

Locations

501 S Sharon Amity Rd
Ste 300
Charlotte, NC 28211
Phone (704) 319-5821

1900 Randolph Rd
Ste 900
Charlotte, NC 28207
Phone (704) 377-2424

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

222 Herlong Ave S
Rock Hill, SC 29732
Phone (803) 324-1950

Organizations & group practices 6

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1093769754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S SHARON AMITY RD",
            "address_2": "STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282110035",
            "telephone_number": "704-377-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 RANDOLPH RD",
            "address_2": "STE 900",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071106",
            "telephone_number": "704-377-2424",
            "fax_number": "704-377-2687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATTERREE",
        "first_name": "JASPER",
        "middle_name": "C",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "38175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "70506",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89-70506",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "930067618",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N38175",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.