Individual provider Active NPI

Aris Ramon Devries, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1255785192
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-06433 Issued in NC
Practice address
445 S Kings Dr
Charlotte, NC 28204-3041
Phone
(980) 308-0141
Fax
(980) 308-0140
NPI assigned
Apr 18, 2016
Last updated
Mar 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 0010-06433 NC Primary

Addresses

Primary practice location

445 S Kings Dr
Charlotte, NC 28204-3041

Mailing address

PO Box 601843
Charlotte, NC 28260-1843

Other practice location 1

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

Other practice location 2

557 Brookdale Dr
Statesville, NC 28677-4107
Phone (704) 873-5661

Other practice location 3

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adevries841588@direct.novanthealth.org

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
I20160815001610 NC Practitioner - Physician Assistant 5890089890 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Practice addresses (Care Compare)

114 S Sharon Amity Rd
Charlotte, NC 28211-2802
Phone (980) 337-4428

116 S Sharon Amity Rd
Charlotte, NC 28211-2802
Phone (980) 337-4428

4304 Park Rd
Charlotte, NC 28209-2271
Phone (704) 272-3395

445 S Kings Dr
Charlotte, NC 28204-3041
Phone (980) 308-0141

5303 Poplar Tent Rd
Suite 90
Concord, NC 28027-9720
Phone (980) 866-4493

8036 Providence Rd
Suite 100
Charlotte, NC 28277-0257
Phone (980) 301-8711

9600 E Independence Blvd
Suite B
Matthews, NC 28105-4628
Phone (704) 815-5624

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-06433NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Medicorp Enterprises, LLC CurrentSince Dec 1, 2020 Accepting new patients
Carolina Medicorp Enterprises, LLC CurrentSince Dec 1, 2020 Accepting new patients
Carolina Medicorp Enterprises Inc Physician Assistant Past Accepting new patients
Emergency Medicine Physicians of Iredell County, PLLC Past Accepting new patients

Locations

445 S Kings Dr
Charlotte, NC 28204
Phone (704) 384-1734

9550 Rocky River Rd
Ste 150
Charlotte, NC 28215
Phone (704) 457-1510

600 Highland Oaks Dr
Winston Salem, NC 27103
Phone (366) 774-0040

Interoperability endpoints

  • Direct secure messaging: adevries841588@direct.novanthealth.org

Organizations & group practices 6

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": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1255785192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601843",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 S KINGS DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043041",
            "telephone_number": "980-308-0141",
            "fax_number": "980-308-0140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Church St N",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252927",
            "country_code": "US",
            "telephone_number": "704-403-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "557 Brookdale Dr",
            "address_purpose": "LOCATION",
            "city": "Statesville",
            "state": "NC",
            "postal_code": "286774107",
            "country_code": "US",
            "telephone_number": "704-873-5661",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "920 Church St N",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252927",
            "country_code": "US",
            "telephone_number": "704-403-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVRIES",
        "first_name": "ARIS",
        "middle_name": "RAMON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-18",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adevries841588@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "445 S Kings Dr",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.