NPIMap

Individual provider Active NPI

Warsha Kumari Mandhan, MD

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1104447366
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2023-02307 Issued in NC
Practice address
11840 Southmore Dr Ste 200
Charlotte, NC 28277-4821
Phone
(704) 384-1166
Fax
(704) 384-1181
NPI assigned
Apr 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 2023-02307 NC Primary

Addresses

Primary practice location

11840 Southmore Dr Ste 200
Charlotte, NC 28277-4821

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

1270 Prince Ave Suite 201
Athens, GA 30606
Phone (706) 475-7055

Other names 1

  • Warsha Kumari Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230905000371 NC Practitioner - Internal Medicine 2567827488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians
The Weston Group IncGroup PAC ID 8123936796, 215 clinicians

Practice addresses (Care Compare)

11840 Southmore Dr
Suite 200
Charlotte, NC 28277-4821
Phone (704) 316-5060

7745 Little Ave
Charlotte, NC 28226-8168
Phone (704) 541-9333

Hospital & facility affiliations

  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
  • Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
  • Novant Health Ballantyne Medical Center Hospital, Charlotte, NC, CCN 340195

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Internal Medicine CurrentSince Aug 15, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 15, 2023 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Internal Medicine Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

11840 Southmore Dr
Ste 200
Charlotte, NC 28277
Phone (704) 384-1166

517 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 384-1406

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

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

Interoperability endpoints

  • Direct secure messaging: wmandhan1148001@direct.novanthealth.org

Organizations & group practices 25

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.

View all 25

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": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1104447366",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11840 SOUTHMORE DR STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774821",
            "telephone_number": "704-384-1166",
            "fax_number": "704-384-1181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1270 Prince Ave Suite 201",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "30606",
            "country_code": "US",
            "telephone_number": "706-475-7055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANDHAN",
        "first_name": "WARSHA KUMARI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-29",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2023-02307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WARSHA",
            "last_name": "KUMARI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.