Individual provider Active NPI

Callaway Brooke Grady, PA

  • Physician Assistant
  • Concord, NC
National Provider Identifier
1184309783
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-13743 Issued in NC
Practice address
100 Medical Park Dr
Ste 210
Concord, NC 28025-2948
Phone
(704) 403-6100
NPI assigned
Jun 20, 2023
Last updated
Sep 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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 0010-13743 NC Primary

Addresses

Primary practice location

100 Medical Park Dr
Ste 210
Concord, NC 28025-2948

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

134 Medical Park Rd
Ste 111 - Adult Cardiology
Mooresville, NC 28117-8526
Phone (704) 801-9100

Other practice location 2

1025 Morehead Medical Dr
Ste 300
Charlotte, NC 28204-2963
Phone (704) 355-1813

Other practice location 3

101 E W T Harris Blvd
Ste 1213
Charlotte, NC 28262-3485
Phone (704) 863-1950

Other practice location 4

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-1255

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address cgrady1254053@CarolinasHealthcareSystem.direct-ci.com Atrium Health

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
I20240130000749 NC Practitioner - Physician Assistant 6305299009 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
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)

100 Medical Park Dr
Concord, NC 28025-2966

134 Medical Park Rd
Suite 111
Mooresville, NC 28117-8527
Phone (704) 801-9100

1550 Faulk St
Suite 3100
Monroe, NC 28112-5197
Phone (704) 667-3410

920 Church St N
Concord, NC 28025-2927
Phone (704) 403-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-13743NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Nov 12, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 11, 2023 Accepting new patients
Carolinas Medical Center CurrentSince Dec 11, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 11, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jul 12, 2024 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Nov 12, 2023 Accepting new patients
Carolinas Medical Center CurrentSince Dec 11, 2023 Accepting new patients

Locations

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

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

101 E Wt Harris Blvd
Ste 1213
Charlotte, NC 28262
Phone (704) 863-1950

1025 Morehead Medical Dr
Ste 200
Charlotte, NC 28204
Phone (704) 302-8000

1025 Morehead Medical Dr
Ste 300
Charlotte, NC 28204
Phone (704) 355-1813

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

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

100 Medical Park Dr
Ste 210
Concord, NC 28025
Phone (704) 403-6100

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

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

Interoperability endpoints

  • Direct secure messaging: cgrady1254053@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 11

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 2

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": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1184309783",
    "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": "100 MEDICAL PARK DR",
            "address_2": "STE 210",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252948",
            "telephone_number": "704-403-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "134 Medical Park Rd",
            "address_2": "Ste 111 - Adult Cardiology",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281178526",
            "country_code": "US",
            "telephone_number": "704-801-9100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 Morehead Medical Dr",
            "address_2": "Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042963",
            "country_code": "US",
            "telephone_number": "704-355-1813",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 E W T Harris Blvd",
            "address_2": "Ste 1213",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623485",
            "country_code": "US",
            "telephone_number": "704-863-1950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-1255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRADY",
        "first_name": "CALLAWAY",
        "middle_name": "BROOKE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2025-09-25",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "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"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cgrady1254053@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "100 Medical Park Dr",
            "address_2": "Ste 210",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.