Chetan N Amin, DO
Individual provider Active NPI Family Medicine Physician · Salisbury, NC
NPI 1104892249 · NPPES record last updated Jun 3, 2013
Key facts
- NPI
- 1104892249
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 200000349 (NC)
- Practice address
- 1401 W Innes St Ste B
Salisbury, NC 28144-2575 - Phone
- (704) 636-5626
- Fax
- (704) 636-5641
- NPI assigned
- Feb 28, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 30
Owned or controlled facilities with NPI records 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Rowan University School of Osteopathic Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Piedmont Family Medicine PA
Legacy Healthcare Services Inc
Practice addresses (Care Compare)
1401 W Innes St
Suite B
Salisbury, NC 28144-2575
Phone (704) 636-5626
548 White Oaks Dr
Salisbury, NC 28147-8183
Phone (704) 636-0271
Hospital & facility affiliations
- Centerwell Home Health
- Bayada Home Health Care, Inc
- Adoration Home Health
- Novant Health Hospice
- Pruitthealth Hospice - Rocky Mount
- Trellis Supportive Care
- Liberty Home Care II, LLC
- Novant Health Hospice and Palliative Care a Department of Novant Health
- Novant Health Rowan Medical Center
- Carolinas Medical Center-Northeast
- Novant Health Presbyterian Medical Center
- Novant Health Huntersville Medical Center
- NC State Veterans Home - Salisbury
- Autumn Care of Salisbury
- Trinity Oaks
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 5
| Facility | Type | Role | Since |
|---|---|---|---|
| Novant Health Rowan Medical Center |
Hospital | Corporate Director | Jan 1, 2024 |
| Novant Health Rowan Medical Center LLC |
Hospital | Corporate Director | Jan 1, 2024 |
| Trinity Oaks |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Oct 1, 2012 Oct 1, 2012 |
| Autumn Care of Salisbury |
Skilled nursing facility | Adp of the SNF | Dec 1, 2018 |
| Novant Health Hospice |
Hospice | Corporate Officer W-2 Managing Employee |
Jan 1, 2024 Jan 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080926000544 | NC | Practitioner - Family Practice |
0345317731 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nicole Graham | Current | Accepting new patients | |
| Piedmont Family Medicine, P.a. | Current |
Accepting new patients | |
| Lutheran Home at Trinity Oaks, Inc. | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
635 Statesville Blvd
Salisbury, NC 28144
Phone (704) 633-7390
1401 W Innes St
Ste B
Salisbury, NC 28144
Phone (704) 636-5626
Interoperability endpoints
- chetan-amin@piedmontfm.e-mdsdirect.com
- admin@piedmontfm.e-mdsdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 200000349 | NC | Yes |
Addresses
Primary practice location
1401 W Innes St Ste B
Salisbury, NC 28144-2575
Mailing address
1401 W Innes St Ste B
Salisbury, NC 28144-2575
Phone (704) 636-5626
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0143736 | Other | UHC | |
| 89127GC | Medicaid | NC | |
| 127GC012MD | Other | NC | BCBS |
| 2401148A | Other | NC | PTAN |
Other providers in Salisbury, NC
- Heather Marie Amaral
- Michael Ambrose
- American Corporate Transportation Ministries
- American Homepatient, Inc.
- Hetal Ajit Amin-Patel
- Kathleen H Amos
- Anchored Community Care Agency
- Crystal D Anderson
- Jimmie Scott Anderson
- Luanne Anderson
All providers in Salisbury, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.