Individual provider Active NPI

Paul E Trombley, MD

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1164593604
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2014-01928 Issued in NC
Practice address
231 S Sharon Amity Rd
Charlotte, NC 28211-2803
Phone
(704) 304-6400
Fax
(704) 442-7021
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2014-01928 NC
Pediatrics Physician 208000000X 2014-01928 NC Primary
Child & Adolescent Psychiatry Physician 2084P0804X 2014-01928 NC

Addresses

Primary practice location

231 S Sharon Amity Rd
Charlotte, NC 28211-2803

Mailing address

PO Box 602148
Charlotte, NC 28260-2148
Phone (704) 304-6400

Other identifiers 2

IdentifierTypeStateIssuer
1164593604MedicaidNC
NC2601MedicaidSC

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150428000717 NC Practitioner - Pediatric MedicinePractitioner - Psychiatry 2567453384 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Psychiatry
Education
University of Tennessee, HSC, College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prospect Behavioral Pediatrics and PsychiatryGroup PAC ID 9133423379, 2 clinicians

Practice addresses (Care Compare)

600 Julian LN
Suite 640
Arden, NC 28704-7812
Phone (828) 552-3504

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014-01928NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Behavioral Pediatrics and Psychiatry Psychiatry CurrentSince Nov 19, 2015 Accepting new patients
DLP Rutherford Physician Practices LLC Pediatrics CurrentSince Dec 9, 2014 Accepting new patients
DLP Rutherford Physician Practices LLC CurrentSince Dec 9, 2014 Accepting new patients
Charles J. McGraw MD, LTD PastSince Jul 30, 2007 Accepting new patients
St. Joseph Primary Care, LLC Pediatrics Past Accepting new patients

Locations

600 Julian Ln
Ste 640
Arden, NC 28704
Phone (828) 552-3504

288 S Ridgecrest Ave
Rutherfordton, NC 28139
Phone (252) 808-6000

Interoperability endpoints

  • Direct secure messaging: paul.trombley.1@12749.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/12749/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1164593604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602148",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602148",
            "telephone_number": "704-304-6400",
            "fax_number": "704-442-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 S SHARON AMITY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112803",
            "telephone_number": "704-304-6400",
            "fax_number": "704-442-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROMBLEY",
        "first_name": "PAUL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2014-01928",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2014-01928",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NC",
            "license": "2014-01928",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164593604",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2601",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.