Andrew Robert Shulstad, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

9900679 Issued in NC

Practice address

6010 Carnegie Blvd
Charlotte, NC 28209-4637

Phone

(704) 384-9966

NPI assigned

Jul 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ashulstad529282@direct.novanthealth.org

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.

• NH Digital Health Services, LLC

  dba Novant Health Digital Care Group

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1427683044
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• NH Digital Health Services, LLC

  dba Novant Health Virtual Oncology Care

  • Hematology & Oncology Physician
  • Winston Salem, NC
  • NPI 1386506855
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Medical Group, Inc.

  dba Novant Health Maternal-Fetal Medicine

  • Maternal & Fetal Medicine Physician
  • Matthews, NC
  • NPI 1033566526
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Northlake Dermatology

  • Dermatopathology Physician
  • Huntersville, NC
  • NPI 1396751640
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1265446942",
    "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": "6010 CARNEGIE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282094637",
            "telephone_number": "704-384-9966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4105 Matthews Mint Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281053633",
            "country_code": "US",
            "telephone_number": "704-384-9966",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4501 Cameron Valley Pkwy",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282114297",
            "country_code": "US",
            "telephone_number": "704-367-7400",
            "fax_number": "704-367-7555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10220 Prosperity Park Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28269",
            "country_code": "US",
            "telephone_number": "704-316-1491",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10220 Prosperity Park Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28269",
            "country_code": "US",
            "telephone_number": "704-316-1491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHULSTAD",
        "first_name": "ANDREW",
        "middle_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9900679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBCBS",
            "identifier": "1232J",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N0067D",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891232J",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ashulstad529282@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "10220 Prosperity Park Dr Ste 300",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ahmed Kareem Shujairi, DDS
• Karan Prabodh Shukla, M.D.
• Manoj Kumar Shukla, APRN
• Debra Bailey Shuler, LPC
• Melissa Shuler
• Jason G Shultz, M.D.
• Robin Shultz, LCSW
• Cheyenne Shuman
• Tara Maree Stegall Shumard, CRNA
• Joscelyn Celeste Shumate Bourne, PT, DPT, CSCS

• Pediatrics Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.