NPIMap

Individual provider Active NPI

Michael Edward Blocker, M.D.

  • Infectious Disease Physician
  • Charlotte, NC
National Provider Identifier
1174586747
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
9600215 Issued in NC
Practice address
1900 Randolph Rd Ste 216
Charlotte, NC 28207-1106
Phone
(704) 316-5330
Fax
(704) 384-5992
NPI assigned
Apr 6, 2006
Last updated
Aug 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 9600215 NC
Infectious Disease Physician 207RI0200X 9600215 NC Primary

Addresses

Primary practice location

1900 Randolph Rd Ste 216
Charlotte, NC 28207-1106

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-5416

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mblocker167014@direct.novanthealth.org

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
I20031112000437 NC Practitioner - Infectious DiseasePractitioner - Internal Medicine 0648183392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
University of Massachusetts Medical School, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-5416

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9600215NCMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 1, 2014 Accepting new patients
Novant Health Medical Group LLC Infectious Disease CurrentSince Aug 1, 2014 Accepting new patients
Burlington Medical Practice, PA Specialist CurrentSince Nov 1, 2003 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients
Private Diagnostic Clinic, PLLC Past Accepting new patients

Locations

1236 Huffman Mill Rd
Ste 2800
Burlington, NC 27215
Phone (336) 538-1030

1248 Huffman Mill Rd
Ste 103
Burlington, NC 27215
Phone (336) 584-5200

1900 Randolph Rd
Ste 216
Charlotte, NC 28207
Phone (704) 316-5330

1900 Randolph Rd
Ste 300
Charlotte, NC 28207
Phone (704) 316-3820

1901 Randolph Rd
Charlotte, NC 28207
Phone (704) 316-2000

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

16525 Holly Crest Ln
Ste 220
Huntersville, NC 28078
Phone (704) 384-1940

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: mblocker167014@direct.novanthealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1174586747",
    "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": "704-384-5416",
            "fax_number": "704-384-5992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 RANDOLPH RD STE 216",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071106",
            "telephone_number": "704-316-5330",
            "fax_number": "704-384-5992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCKER",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "9600215",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NC",
            "license": "9600215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mblocker167014@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1900 Randolph Rd Ste 216",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282071106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.