Individual provider Active NPI

Robert L. Mittl Jr., M.D.

  • Diagnostic Radiology Physician
  • Charlotte, NC
National Provider Identifier
1174522528
Registry record updated Dec 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
36778 Issued in NC
Practice address
700 E Morehead St Ste 300
Charlotte, NC 28202-2742
Phone
(704) 334-7800
Fax
(704) 414-7512
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 36778 NC
Diagnostic Radiology Physician 2085R0202X 20165 SC
Diagnostic Radiology Physician 2085R0202X 36778 NC Primary

Addresses

Primary practice location

700 E Morehead St Ste 300
Charlotte, NC 28202-2742

Mailing address

700 E Morehead St Ste 300
Charlotte, NC 28202-2742
Phone (704) 334-7800

Other practice location 1

1701 East Blvd
Charlotte Radiology
Charlotte, NC 28203-5823
Phone (704) 334-7800

Other identifiers 1

IdentifierTypeStateIssuer
8959865MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051101000772 NC Practitioner - Diagnostic Radiology 9234156902 Reassigns benefits to 2 organizations
I20130712000540 SC Practitioner - Diagnostic Radiology 9234156902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Washington School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charlotte Radiology PAGroup PAC ID 4587577390, 222 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 362-1945

1000 Healing Way
Matthews, NC 28104-4969
Phone (800) 821-1535

1010 E Dixon Blvd
Suite B
Shelby, NC 28152-6838
Phone (980) 487-2900

1025 Morehead Medical Dr
Suite 100
Charlotte, NC 28204-2964
Phone (704) 326-1945

1045 Negateway NE CT
Concord, NC 28025-2440
Phone (704) 362-1945

1045 Negateway Nect
Cocnord, NC 28025-2440
Phone (704) 334-7800

10628 Park Rd
Charlotte, NC 28210-8407
Phone (704) 362-1945

10648 Park Rd
Charlotte, NC 28210-8407
Phone (704) 362-5391

1065 Negateway Nect
Concord, NC 28025-2440
Phone (704) 334-7800

12016 Lemmond Farm Dr
Suite 100
Charlotte, NC 28227-8353
Phone (704) 863-9600

12905 Rosedale Hill Ave
Huntersville, NC 28078-3341
Phone (704) 801-1000

13640 Steelecroft Pkwy
Charlotte, NC 28278-7565
Phone (704) 334-7800

16035 Johnston Rd
Charlotte, NC 28277-2566
Phone (704) 667-0950

1656 Riverchase Blvd
Suite 1200
Rock Hill, SC 29732-0270
Phone (803) 327-9934

1802 E Main St
Lincolnton, NC 28092-3915
Phone (980) 212-2610

225 Baldwin Ave
Charlotte, NC 28204-3109
Phone (704) 362-1945

2700 Providence Rd S
Waxhaw, NC 28173-6313
Phone (704) 334-7800

2711 Lane St
Kannapolis, NC 28083-9217
Phone (704) 334-7800

332 N Trade St
Suite 2000
Matthews, NC 28105-1728
Phone (704) 302-8500

433 McAlister Rd
Lincolnton, NC 28092-4147
Phone (704) 362-1945

500 Morven Rd
Wadesboro, NC 28170-2745
Phone (704) 362-1945

5717 Albemarle Rd
Charlotte, NC 28212-1634
Phone (704) 563-2150

600 Hospital Dr
Monroe, NC 28112-6000
Phone (704) 362-1945

6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000

724 Aubrey Bell Dr
Matthews, NC 28105-5055
Phone (704) 295-3550

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Carolinas Medical Center-Northeast Hospital, Concord, NC, CCN 340001
  • Atrium Health Pineville Hospital, Charlotte, NC, CCN 340098
  • Atrium Health Union Hospital, Monroe, NC, CCN 340130
  • Atrium Health Cleveland Hospital, Shelby, NC, CCN 340021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36778NCMDDiagnostic Radiology Physician
20165SCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Healthcare Medical Group Inc Diagnostic Radiology CurrentSince Jun 16, 2019 Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. CurrentSince Jun 16, 2019 Accepting new patients
Charlotte Radiology PA Diagnostic Radiology CurrentSince May 14, 2013 Accepting new patients
Carolinas Imaging Services, LLC CurrentSince Jul 18, 2017 Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. Current Accepting new patients

Locations

1701 East Blvd
Charlotte, NC 28203

700 E Morehead St
Ste 300
Charlotte, NC 28202
Phone (704) 442-4390

2134 14th Avenue Cir NW
Ste D
Hickory, NC 28601
Phone (828) 580-1236

2293 Sugar Hill Rd
#G
Marion, NC 28752

2209 S Sterling St
Ste 200
Morganton, NC 28655
Phone (828) 580-6572

2201 S Sterling St
Morganton, NC 28655
Phone (828) 580-6393

1656 Riverchase Blvd
Ste 1200
Rock Hill, SC 29732
Phone (803) 327-9934

Organizations & group practices 6

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 12

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1174522528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022742",
            "telephone_number": "704-334-7800",
            "fax_number": "704-414-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022742",
            "telephone_number": "704-334-7800",
            "fax_number": "704-414-7512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 East Blvd",
            "address_2": "Charlotte Radiology",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035823",
            "country_code": "US",
            "telephone_number": "704-334-7800",
            "fax_number": "704-414-7512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITTL",
        "first_name": "ROBERT",
        "middle_name": "L.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NC",
            "license": "36778",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "20165",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "36778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8959865",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.