Individual provider Active NPI

Sarah Kathryn Bagley, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1134583701
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-13260 Issued in NC
Practice address
10905 Providence Rd W
Ste 270
Charlotte, NC 28277-1538
Phone
(704) 316-3410
Fax
(704) 316-3420
NPI assigned
Apr 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-13260 NC Primary
Physician Assistant 363A00000X

Addresses

Primary practice location

10905 Providence Rd W
Ste 270
Charlotte, NC 28277-1538

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-3410

Other practice location 1

1720 University Dr S
Fargo, ND 58103-4940
Phone (701) 417-6000

Other practice location 2

4622 40th Ave S
Fargo, ND 58104-4394
Phone (701) 364-2909

Other names 1

  • Sarah Kathryn Driscoll Former 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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230706001475 NC Practitioner - Physician Assistant 5597056903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians

Practice addresses (Care Compare)

10905 Providence Rd W
Charlotte, NC 28277-1538

12611 N Community House Rd
Suite 100
Charlotte, NC 28277-3817
Phone (704) 316-3410

1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone (704) 384-6500

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

Hospital & facility affiliations

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
7750AZMDChiropractor
0010-13260NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince May 30, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 30, 2023 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

4741 Randolph Rd
Ste 100200
Charlotte, NC 28211
Phone (704) 365-6730

10905 Providence Rd W
Ste 270
Charlotte, NC 28277
Phone (704) 316-3410

1450 Matthews Township Pkwy
Ste 170
Matthews, NC 28105
Phone (704) 384-6020

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: sbagley1122886@direct.novanthealth.org

Organizations & group practices 5

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.

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": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1134583701",
    "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": "704-316-3410",
            "fax_number": "704-316-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10905 PROVIDENCE RD W",
            "address_2": "STE 270",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282771538",
            "telephone_number": "704-316-3410",
            "fax_number": "704-316-3420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 University Dr S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581034940",
            "country_code": "US",
            "telephone_number": "701-417-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4622 40th Ave S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581044394",
            "country_code": "US",
            "telephone_number": "701-364-2909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAGLEY",
        "first_name": "SARAH",
        "middle_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13260",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "DRISCOLL",
            "middle_name": "KATHRYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.