Individual provider Active NPI

Harold Truett Smith Jr., PA

  • Physician Assistant
  • Concord, NC
National Provider Identifier
1174590590
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
101221 Issued in NC
Practice address
10030 Edison Square Dr NW
Ste 100
Concord, NC 28027-8308
Phone
(704) 403-7830
NPI assigned
Mar 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 101221 NC Primary

Addresses

Primary practice location

10030 Edison Square Dr NW
Ste 100
Concord, NC 28027-8308

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

5727 Prosperity Crossing Dr
Ste 1100
Charlotte, NC 28269-2206
Phone (704) 863-9930

Other practice location 2

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

Other practice location 3

7810 Providence Rd
Ste 102
Charlotte, NC 28226-2954
Phone (704) 543-6636

Other practice location 4

10210 Couloak Dr
Ste E
Charlotte, NC 28216-7679
Phone (704) 801-2000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tsmith128937@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

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
I20070711000156 NC Practitioner - Physician Assistant 9032219753 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, shared by 56 NPIs, 2,324 clinicians

Practice addresses (Care Compare)

10030 Edison Square Dr NW
Suite 100
Concord, NC 28027-8309
Phone (704) 403-7830

14214 Ballantyne Lake Rd
Charlotte, NC 28277-3373

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Carolinas Medical Center-Northeast Hospital, Concord, NC, CCN 340001
  • Atrium Health University City Hospital, Charlotte, NC, CCN 340166

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
101221NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince May 10, 2011 Accepting new patients
Arboretum Urgent Care Center CurrentSince May 10, 2011 Accepting new patients
Carolinas Physicians Network Inc CurrentSince May 10, 2011 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Dec 1, 2013 Accepting new patients
Carolinas Physicians Network Inc CurrentSince May 10, 2011 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Dec 1, 2013 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Union Urgent Care LLC Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Union Urgent Care LLC Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

10210 Couloak Dr
Ste E
Charlotte, NC 28216
Phone (704) 801-2000

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

7810 Providence Rd
Ste 102
Charlotte, NC 28226
Phone (704) 393-4808

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

231 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 304-6400

5435 Prosperity Church Rd
Ste 2200
Charlotte, NC 28269
Phone (704) 863-9830

9332 S Tryon St
Charlotte, NC 28273
Phone (704) 587-6700

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

5727 Prosperity Crossing Dr
Ste 1100
Charlotte, NC 28269
Phone (704) 863-9930

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

10030 Edison Square Dr NW
Ste 100
Concord, NC 28027
Phone (704) 403-7830

1085 NE Gateway Ct NE
#200A
Concord, NC 28025
Phone (704) 403-8650

1090 NE Gateway Ct NE
Ste 202
Concord, NC 28025
Phone (704) 403-9050

705 Griffith St
Ste 100
Davidson, NC 28036
Phone (704) 801-7900

4315 Physicians Blvd
Ste 201
Harrisburg, NC 28075
Phone (704) 455-5508

16455 Statesville Rd
Ste 100
Huntersville, NC 28078
Phone (704) 801-1701

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

6030 W Highway 74
Indian Trail, NC 28079
Phone (704) 246-2777

332 N Trade St
#1100
Matthews, NC 28105
Phone (704) 512-6850

8560 Cook St
Mt Pleasant, NC 28124
Phone (704) 403-1911

Interoperability endpoints

  • Direct secure messaging: tsmith128937@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 9

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1174590590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10030 EDISON SQUARE DR NW",
            "address_2": "STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280278308",
            "telephone_number": "704-403-7830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5727 Prosperity Crossing Dr",
            "address_2": "Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282692206",
            "country_code": "US",
            "telephone_number": "704-863-9930",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5717 Albemarle Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282121634",
            "country_code": "US",
            "telephone_number": "704-563-2150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7810 Providence Rd",
            "address_2": "Ste 102",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282262954",
            "country_code": "US",
            "telephone_number": "704-543-6636",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10210 Couloak Dr",
            "address_2": "Ste E",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282167679",
            "country_code": "US",
            "telephone_number": "704-801-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "HAROLD",
        "middle_name": "TRUETT",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2024-07-15",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "101221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tsmith128937@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "10030 Edison Square Dr NW",
            "address_2": "Ste 100",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280278308",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.