NPIMap

Individual provider Active NPI

John Labs, PA

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1255314134
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103861 Issued in NC
Practice address
1900 Randolph Rd Ste 1016
Charlotte, NC 28207-1117
Phone
(704) 347-3447
Fax
(704) 347-3440
NPI assigned
Nov 23, 2005
Last updated
Jul 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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 103861 NC Primary

Addresses

Primary practice location

1900 Randolph Rd Ste 1016
Charlotte, NC 28207-1117

Mailing address

PO Box 1844
Bryson City, NC 28713-1844
Phone (980) 270-6770

Other practice location 1

945 N 5th St
Albemarle, NC 28001-3417
Phone (980) 323-7790

Other identifiers 2

IdentifierTypeStateIssuer
1611COtherNCBCBS NC
1255314134MedicaidNC

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
I20031208000373 NC Practitioner - Physician Assistant 4284530700 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ubylee Healthcare Group, PLLC CurrentSince Dec 1, 2019 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince May 5, 2014 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince May 5, 2014 Accepting new patients
Carolinas Medical Center CurrentSince Nov 6, 2017 Accepting new patients
Carolinas Medical Center CurrentSince Nov 6, 2017 Accepting new patients

Locations

945 N 5th St
Albemarle, NC 28001
Phone (980) 323-7790

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

441 McAlister Rd
Ste 1200
Lincolnton, NC 28092
Phone (980) 212-6200

1212 Mann Dr
Ste 200
Matthews, NC 28105
Phone (980) 262-3007

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1255314134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1844",
            "city": "BRYSON CITY",
            "state": "NC",
            "postal_code": "287131844",
            "telephone_number": "980-270-6770",
            "fax_number": "828-538-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 RANDOLPH RD STE 1016",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071117",
            "telephone_number": "704-347-3447",
            "fax_number": "704-347-3440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "945 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Albemarle",
            "state": "NC",
            "postal_code": "280013417",
            "country_code": "US",
            "telephone_number": "980-323-7790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LABS",
        "first_name": "JOHN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "1611C",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255314134",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.