Individual provider Active NPI

George Anthony Manousos, MD

  • Pediatrics Physician
  • Matthews, NC
National Provider Identifier
1285659938
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
200400376 Issued in NC
Practice address
332 N Trade St
Ste 1500
Matthews, NC 28105-1728
Phone
(704) 512-6820
NPI assigned
Jul 13, 2006
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 200400376 NC Primary
Hospitalist Physician 208M00000X 200400376 NC

Addresses

Primary practice location

332 N Trade St
Ste 1500
Matthews, NC 28105-1728

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

6235 Blakeney Park Dr
Ste 100
Charlotte, NC 28277-5658
Phone (704) 512-5060

Other practice location 2

4501 Cameron Valley Pkwy
Ste 100
Charlotte, NC 28211-4297
Phone (704) 367-7400

Other practice location 3

1001 Blythe Blvd
Medical Center Plaza, Suite 200
Charlotte, NC 28203-5866
Phone (704) 381-8840

Other practice location 4

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-1422

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address gmanousos128523@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050803001138 NC Practitioner - Pediatric Medicine 9032147608 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200400376NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center Pediatrics Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 1, 2025 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Medical Center Pediatrics CurrentSince Aug 21, 2017 Accepting new patients
Charlotte Pediatric Clinic Pediatrics CurrentSince Nov 24, 2019 Accepting new patients
Carolinas Physician Network Inc Pediatrics CurrentSince Jan 1, 2025 Accepting new patients
Carolinas Medical Center CurrentSince Aug 21, 2017 Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients
Charlotte Pediatric Clinic Pediatrics PastSince Nov 24, 2019 Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

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

1001 Blythe Blvd
Ste 200
Charlotte, NC 28203
Phone (704) 373-0544

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

4501 Cameron Valley Pkwy
Ste 100
Charlotte, NC 28211
Phone (704) 367-7400

6235 Blakeney Park Dr
Ste 100
Charlotte, NC 28277
Phone (704) 512-5060

332 N Trade St
Matthews, NC 28105
Phone (704) 302-8500

332 N Trade St
Ste 1500
Matthews, NC 28105
Phone (704) 512-6820

Interoperability endpoints

  • Direct secure messaging: gmanousos128523@carolinashealthcaresystem.direct-ci.com

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1285659938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 N TRADE ST",
            "address_2": "STE 1500",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281051728",
            "telephone_number": "704-512-6820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6235 Blakeney Park Dr",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282775658",
            "country_code": "US",
            "telephone_number": "704-512-5060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4501 Cameron Valley Pkwy",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282114297",
            "country_code": "US",
            "telephone_number": "704-367-7400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 Blythe Blvd",
            "address_2": "Medical Center Plaza, Suite 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035866",
            "country_code": "US",
            "telephone_number": "704-381-8840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-1422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANOUSOS",
        "first_name": "GEORGE",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200400376",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "200400376",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmanousos128523@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "332 N Trade St",
            "address_2": "Ste 1500",
            "city": "Matthews",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281051728",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.