Active NPI
Jamie Seidl, DO
- Family Medicine Physician
- Mooresville, NC
National Provider Identifier
1174964225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2020-00355
- Practice address
- 106 Langtree Village Dr Ste 200
Mooresville, NC 28117-7594 - Phone
- (704) 384-7101
- Fax
- (704) 384-7102
- NPI assigned
- Jul 17, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | DO-04671 | IA | |
| Family Medicine Physician | 207Q00000X | 2020-00355 | NC | Primary |
Addresses
Primary practice location
106 Langtree Village Dr Ste 200
Mooresville, NC 28117-7594
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Other practice location 1
300 East Hospital Road
Fort Gordon, GA 30905
Phone (706) 787-9358
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jseidl822832@direct.novanthealth.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO-04671 | IA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603670400000",
"number": "1174964225",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 LANGTREE VILLAGE DR STE 200",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281177594",
"telephone_number": "704-384-7101",
"fax_number": "704-384-7102"
}
],
"practiceLocations": [
{
"address_1": "300 East Hospital Road",
"address_purpose": "LOCATION",
"city": "Fort Gordon",
"state": "GA",
"postal_code": "30905",
"country_code": "US",
"telephone_number": "706-787-9358",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SEIDL",
"first_name": "JAMIE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-07-17",
"last_updated": "2020-10-26",
"certification_date": "2020-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "DO-04671",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "2020-00355",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jseidl822832@direct.novanthealth.org",
"affiliation": "N",
"address_1": "300 East Hospital Road",
"city": "Fort Gordon",
"state": "GA",
"country_code": "US",
"postal_code": "30905",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Mooresville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.