NPIMap

Individual provider Active NPI

Jason G Shultz, M.D.

  • Medical Oncology Physician
  • Charlotte, NC
National Provider Identifier
1245468685
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
2014-01354 Issued in NC
Practice address
125 Queens Rd Ste 430
Charlotte, NC 28204-3579
Phone
(980) 302-6700
Fax
(980) 302-6705
NPI assigned
Jun 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 2014-01354 NC Primary

Addresses

Primary practice location

125 Queens Rd Ste 430
Charlotte, NC 28204-3579

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other identifiers 3

IdentifierTypeStateIssuer
189ABOtherNCBCBS NC
1245468685MedicaidNC
2014-01354OtherNCNC LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jshultz165048@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
I20140818000318 NC Practitioner - Hematology/Oncology 6305063272 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Presbyterian HospitalGroup PAC ID 1153231907, 412 clinicians

Practice addresses (Care Compare)

10905 Providence Rd W
Suite 150
Charlotte, NC 28277-1538
Phone (980) 302-7120

125 Queens Rd
Suite 430
Charlotte, NC 28204-3579
Phone (980) 302-6700

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-9073

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Jul 1, 2016 Accepting new patients
The Presbyterian Hospital Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Medical Group Inc Hematology & Oncology CurrentSince Jul 1, 2016 Accepting new patients
The Presbyterian Hospital Hematology & Oncology CurrentSince Feb 1, 2019 Accepting new patients
The Presbyterian Hospital CurrentSince Feb 1, 2019 Accepting new patients
Novant Health Medical Group Coastal Region, LLC Hematology & Oncology Past Accepting new patients
Novant Medical Group, Inc. Past Accepting new patients

Locations

125 Queens Rd
Ste 430
Charlotte, NC 28204
Phone (980) 302-6300

1718 E 4th St
Ste 707
Charlotte, NC 28204
Phone (704) 316-4485

125 Queens Rd
Ste 640
Charlotte, NC 28204
Phone (980) 302-6761

10905 Providence Rd W
Ste 150
Charlotte, NC 28277
Phone (980) 302-7120

7108 Pineville Matthews Rd
Ste 102
Charlotte, NC 28226
Phone (704) 342-1900

125 Queens Rd
Charlotte, NC 28204
Phone (980) 302-6380

8201 Healthcare Loop
Ste 201
Charlotte, NC 28215
Phone (704) 316-3024

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

125 Queens Rd
Ste 400
Charlotte, NC 28204
Phone (980) 302-6400

10030 Gilead Rd
Ste 350
Huntersville, NC 28078
Phone (704) 799-3946

1700 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 841-8151

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

1010 Bethesda Ct
Winston Salem, NC 27103
Phone (336) 277-6000

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: jshultz165048@direct.novanthealth.org

Organizations & group practices 8

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.

Hospital & facility affiliations 8

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": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1245468685",
    "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": "125 QUEENS RD STE 430",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043579",
            "telephone_number": "980-302-6700",
            "fax_number": "980-302-6705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULTZ",
        "first_name": "JASON",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-24",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NC",
            "license": "2014-01354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "189AB",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245468685",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC LICENSE",
            "identifier": "2014-01354",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jshultz165048@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "125 Queens Rd Ste 640",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.