Individual provider Active NPI

Richelle Patricia Pennington

  • Physician Assistant
  • Belmont, NC
National Provider Identifier
1275096158
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001011689 Issued in NC
Practice address
275 Beatty Dr
Belmont, NC 28012-2715
Phone
(704) 822-2550
NPI assigned
Apr 9, 2019
Last updated
Aug 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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 001011689 NC Primary
Medical Physician Assistant 363AM0700X 023671 NY

Addresses

Primary practice location

275 Beatty Dr
Belmont, NC 28012-2715

Mailing address

275 Beatty Dr
Belmont, NC 28012-2715
Phone (704) 822-2550

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
I20220208001766 NC Practitioner - Physician Assistant 1052640943 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001011689NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc CurrentSince Feb 14, 2022 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Aug 5, 2025 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Aug 5, 2025 Accepting new patients
Caromont Medical Group Inc CurrentSince Feb 14, 2022 Accepting new patients

Locations

275 Beatty Dr
Belmont, NC 28012
Phone (704) 355-9330

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

2544 Court Dr
Ste G
Gastonia, NC 28054
Phone (704) 854-9990

2555 Court Dr
Ste 200
Gastonia, NC 28054
Phone (704) 671-7670

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

Interoperability endpoints

  • Direct secure messaging: rpennington2995869@carolinashealthcaresystem.direct-ci.com

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": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1275096158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 BEATTY DR",
            "city": "BELMONT",
            "state": "NC",
            "postal_code": "280122715",
            "telephone_number": "704-822-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 BEATTY DR",
            "city": "BELMONT",
            "state": "NC",
            "postal_code": "280122715",
            "telephone_number": "704-822-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "RICHELLE",
        "middle_name": "PATRICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-09",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001011689",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "023671",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, NC

Sources for this page

Verify at the official NPI Registry.