Individual provider Active NPI

Sophia Helena Theodos, MD, MPH

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1194475889
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2025-00800 Issued in NC
Practice address
10620 Park Rd Ste 202
Charlotte, NC 28210-0106
Phone
(844) 235-6999
Fax
(704) 468-0089
NPI assigned
Mar 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2025-00800 NC Primary

Addresses

Primary practice location

10620 Park Rd Ste 202
Charlotte, NC 28210-0106

Mailing address

10620 Park Rd Ste 202
Charlotte, NC 28210-0106

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
I20251106005126 NC Practitioner - Family Practice 8325428097 Reassigns benefits to 1 organization
I20251125004782 SC Practitioner - Family Practice 8325428097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Alabama School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, shared by 56 NPIs, 2,324 clinicians

Practice addresses (Care Compare)

10620 Park Rd
Suite 202
Charlotte, NC 28210-0106
Phone (704) 667-0920

704 Gold Hill Rd
Suite 1200
Fort Mill, SC 29715-8906
Phone (704) 667-3380

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025-00800NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Nov 7, 2025 Accepting new patients
Carolinas Physicians Network, Inc Family Medicine CurrentSince Nov 7, 2025 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Nov 17, 2025 Accepting new patients

Locations

10620 Park Rd
Ste 202
Charlotte, NC 28210
Phone (704) 512-3988

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

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

704 Gold Hill Rd
Ste 1200
Fort Mill, SC 29715
Phone (704) 667-3380

Interoperability endpoints

  • Direct secure messaging: stheodos1252415@direct.novanthealth.org
  • Direct secure messaging: stheodos3047528@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1194475889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10620 PARK RD STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282100106",
            "fax_number": "704-468-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10620 PARK RD STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282100106",
            "telephone_number": "844-235-6999",
            "fax_number": "704-468-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODOS",
        "first_name": "SOPHIA",
        "middle_name": "HELENA",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-25",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2025-00800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.