Individual provider Active NPI

Robert A Nahouraii, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Concord, NC
National Provider Identifier
1104877224
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
52034 Issued in SC
Practice address
70 Lake Concord Rd NE
Concord, NC 28025-3057
Phone
(704) 355-9794
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 52034 SC
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 35174 NC
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 52034 SC Primary

Addresses

Primary practice location

70 Lake Concord Rd NE
Concord, NC 28025-3057

Mailing address

5522 Selsey PL
Charlotte, NC 28277-0514
Phone (704) 618-5362

Other practice location 1

9 Richland Medical Park Dr Ste 110
Columbia, SC 29203
Phone (803) 434-7961

Other identifiers 2

IdentifierTypeStateIssuer
8962907MedicaidNC
N35174MedicaidSC

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
I20060207000750 NC Practitioner - NeurologyPractitioner - Pediatric Medicine 1153336532 Reassigns benefits to 1 organization
I20180514000241 SC Practitioner - Pediatric Medicine 1153336532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Pediatric Medicine
Education
University of Pittsburgh School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alzheimer's Memory CenterGroup PAC ID 8022188549, 5 clinicians
Mecklenburg Neurology GroupGroup PAC ID 4385999408, 6 clinicians

Practice addresses (Care Compare)

10801 Monroe Rd
Suite 100
Matthews, NC 28105-8336
Phone (704) 364-4000

70 Lake Concord Rd NE
Concord, NC 28025-3057

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35174NCMDNeurology with Special Qualifications in Child Neurology Physician
52034SCMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mecklenburg Neurology Group CurrentSince Nov 20, 2020 Accepting new patients

Locations

3541 Randolph Rd
Ste 301
Charlotte, NC 28211
Phone (704) 335-9794

1300 Baxter St
Ste 114
Charlotte, NC 28204
Phone (704) 333-3033

8001 N Tryon St
Charlotte, NC 28262
Phone (704) 335-9794

70 Lake Concord Rd NE
Concord, NC 28025
Phone (704) 335-3400

511 Lauchwood Dr
Laurinburg, NC 28352
Phone (704) 335-9794

1665 Herlong Ct
#B
Rock Hill, SC 29732
Phone (803) 324-1028

Interoperability endpoints

  • Direct secure messaging: robertnahouraiimd@meckneurology.medentdirect.com
  • Direct secure messaging: rnahouraii2905900@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 2

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": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1104877224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5522 SELSEY PL",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282770514",
            "telephone_number": "704-618-5362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 LAKE CONCORD RD NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253057",
            "telephone_number": "704-355-9794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9 Richland Medical Park Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "29203",
            "country_code": "US",
            "telephone_number": "803-434-7961",
            "fax_number": "803-434-7981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAHOURAII",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "52034",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NC",
            "license": "35174",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "SC",
            "license": "52034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8962907",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N35174",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.