Individual provider Active NPI

Ann Michelle Smolin

  • Clinical Psychologist
  • Charlotte, NC
National Provider Identifier
1114081668
Registry record updated Feb 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4236 Issued in NC
Practice address
5970 Fairview Rd Ste 412
Charlotte, NC 28210-2105
Phone
(980) 430-3896
Fax
(704) 362-1170
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 4236 NC Primary

Addresses

Primary practice location

5970 Fairview Rd Ste 412
Charlotte, NC 28210-2105

Mailing address

5970 Fairview Rd Ste 412
Charlotte, NC 28210-2105
Phone (980) 430-3896

Other names 1

  • Dr. Ann Isaacs-Smolin Other name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120724001043 NC Practitioner - Clinical Psychologist 6709967920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5970 Fairview Rd
Suite 412
Charlotte, NC 28210-2105

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4236NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ann Smolin, PH.D., PLLC Clinical CurrentSince Feb 26, 2012 Accepting new patients
Caron of Georgia LLC Past Accepting new patients
Kenneth C. Frontman, PH.D., PC Clinical Past Accepting new patients

Locations

5970 Fairview Rd
Ste 412
Charlotte, NC 28210
Phone (704) 362-1147

4425 Randolph Rd
Ste 411
Charlotte, NC 28211
Phone (704) 362-5355

Interoperability endpoints

  • Direct secure messaging: ann.smolin@direct.annsmolinphd.nchie.net

Organizations & group practices 3

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739664000000",
    "number": "1114081668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5970 FAIRVIEW RD STE 412",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282102105",
            "telephone_number": "980-430-3896",
            "fax_number": "704-362-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5970 FAIRVIEW RD STE 412",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282102105",
            "telephone_number": "980-430-3896",
            "fax_number": "704-362-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOLIN",
        "first_name": "ANN",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2025-02-16",
        "certification_date": "2025-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "4236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "ISAACS-SMOLIN",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.