Individual provider Active NPI

Vanesh Khetpal, MD

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1093946832
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2012-01509 Issued in NC
Practice address
200 Hawthorne LN
Charlotte, NC 28204-2515
Phone
(704) 384-5416
Fax
(704) 384-5992
NPI assigned
Jul 28, 2009
Last updated
Oct 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2012-01509 NC Primary
Hospitalist Physician 208M00000X 2012-01509 NC

Addresses

Primary practice location

200 Hawthorne LN
Charlotte, NC 28204-2515

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-5416

Other practice location 1

500 Lauchwood Dr
Laurinburg, NC 28352-5501
Phone (910) 291-6904

Other practice location 2

300 W 27th St
Lumberton, NC 28358-3075
Phone (910) 671-5000

Other practice location 3

730 Oakridge Blvd
Lumberton, NC 28358-2324
Phone (910) 738-2662

Other identifiers 2

IdentifierTypeStateIssuer
1093946832MedicaidNC
NC2057MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vkhetpal847835@direct.novanthealth.org

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
I20120824000778 NC Practitioner - HospitalistPractitioner - Family Practice 9234386384 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians
Robeson Hospitalist Group PLLCGroup PAC ID 2567898430, 33 clinicians

Practice addresses (Care Compare)

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-5416

300 W 27TH St
Lumberton, NC 28358-3075
Phone (910) 671-5000

730 Oakridge Blvd
Lumberton, NC 28358-2324
Phone (910) 738-2662

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012-01509NCMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catawba Piedmont Cardiothoracic Surgery LLC CurrentSince Oct 1, 2015 Accepting new patients
Southeastern Regional Physician Services CurrentSince Sep 9, 2024 Accepting new patients
Robeson Hospitalist Group PLLC Hospitalist CurrentSince Jan 1, 2020 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Carolinas Physicians Network Inc Hospitalist CurrentSince Nov 7, 2022 Accepting new patients
Vidant Medical Group LLC CurrentSince Feb 15, 2019 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Dec 17, 2020 Accepting new patients
Southeastern Regional Physician Services CurrentSince Sep 9, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Nov 7, 2022 Accepting new patients
Vidant Medical Group LLC CurrentSince Feb 15, 2019 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Novant Health Medical Group, LLC Hospitalist CurrentSince Dec 17, 2020 Accepting new patients
Southeastern Regional Medical Center Past Accepting new patients
Columbus Regional Health Network Family Medicine Past Accepting new patients
Southeastern Regional Medical Center Hospitalist Past Accepting new patients
Southeastern Regional Medical Center Past Accepting new patients

Locations

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1901 Randolph Rd
Charlotte, NC 28207
Phone (704) 316-2000

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

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

300 W 27th St
Lumberton, NC 28358
Phone (910) 671-5000

395 W 27th St
Lumberton, NC 28358
Phone (910) 738-3434

730 Oakridge Blvd
Lumberton, NC 28358
Phone (910) 738-2662

5221 Paramount Pkwy
Ste 220
Morrisville, NC 27560
Phone (984) 215-4110

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

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

200 Herlong Ave S
Ste E1
Rock Hill, SC 29732
Phone (803) 324-1950

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: vkhetpal27131@directmcleodehealth.org

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 16

Hospital & facility affiliations 6

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": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1093946832",
    "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": "704-384-5416",
            "fax_number": "704-384-5992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWTHORNE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042515",
            "telephone_number": "704-384-5416",
            "fax_number": "704-384-5992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Lauchwood Dr",
            "address_purpose": "LOCATION",
            "city": "Laurinburg",
            "state": "NC",
            "postal_code": "283525501",
            "country_code": "US",
            "telephone_number": "910-291-6904",
            "fax_number": "910-291-6907",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 W 27th St",
            "address_purpose": "LOCATION",
            "city": "Lumberton",
            "state": "NC",
            "postal_code": "283583075",
            "country_code": "US",
            "telephone_number": "910-671-5000",
            "fax_number": "910-291-6907",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "730 Oakridge Blvd",
            "address_purpose": "LOCATION",
            "city": "Lumberton",
            "state": "NC",
            "postal_code": "283582324",
            "country_code": "US",
            "telephone_number": "910-738-2662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHETPAL",
        "first_name": "VANESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-28",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2012-01509",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2012-01509",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093946832",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2057",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vkhetpal847835@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "200 Hawthorne Ln",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.