NPIMap

Individual provider Active NPI

Jonathan Richard Peyton

  • Oral Medicine Dentistry
  • Charlotte, NC
National Provider Identifier
1154053445
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral Medicine DentistryTaxonomy code 125Q00000X
License
0295 Issued in NC
Practice address
CMC Dental Clinic
1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone
(704) 355-2165
Fax
(704) 355-8856
NPI assigned
Jun 27, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0295 NC
General Practice Dentistry 1223G0001X 0295 NC
Oral Medicine Dentistry 125Q00000X 0295 NC Primary

Addresses

Primary practice location

CMC Dental Clinic
1000 Blythe Blvd
Charlotte, NC 28203-5812

Mailing address

558 E Brooklyn Village Ave Apt 313
Charlotte, NC 28202-3436
Phone (980) 808-7035

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://atriumhealth.org/locations/detail/atrium-health-dental-clinic

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
I20250917002914 NC Practitioner - Dentist 4284002064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Charlotte-Mecklenburg Hospital AuthorityGroup PAC ID 2365353885, 9 clinicians

Practice addresses (Care Compare)

1601 Abbey PL
Suite 220
Charlotte, NC 28209-3825
Phone (704) 512-2110

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Atrium Health University City Hospital, Charlotte, NC, CCN 340166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Aug 10, 2025 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Dentist CurrentSince Aug 10, 2025 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Past Accepting new patients

Locations

1601 Abbey Pl
Ste 220
Charlotte, NC 28209
Phone (704) 512-2110

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1000 Blythe Blvd
Fl 2
Charlotte, NC 28203
Phone (704) 355-2165

1000 Blythe Blvd
Bldg 2ND
Charlotte, NC 28203
Phone (704) 355-2165

Interoperability endpoints

  • Direct secure messaging: jpeyton908195@carolinashealthcaresystem.direct-ci.com

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.

Hospital & facility affiliations 7

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": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1154053445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "558 E BROOKLYN VILLAGE AVE APT 313",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282023436",
            "telephone_number": "980-808-7035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CMC DENTAL CLINIC",
            "address_2": "1000 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-355-2165",
            "fax_number": "704-355-8856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEYTON",
        "first_name": "JONATHAN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "0295",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "0295",
            "primary": false
        },
        {
            "code": "125Q00000X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral Medicine",
            "state": "NC",
            "license": "0295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://atriumhealth.org/locations/detail/atrium-health-dental-clinic",
            "affiliation": "N",
            "endpointDescription": "website URL",
            "address_1": "CMC Dental Clinic",
            "address_2": "1000 Blythe Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282035812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.