Active NPI
Nichole Ann Waltz, PA
- Physician Assistant
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-01323
- Practice address
- 416 E 36TH St
Ste 200
Charlotte, NC 28205-1030 - Phone
- (980) 302-9800
- Fax
- (980) 302-9810
- NPI assigned
- Jun 11, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-01323 | NC | Primary |
Addresses
Primary practice location
416 E 36TH St
Ste 200
Charlotte, NC 28205-1030
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Other practice location 1
332 N Trade St
Suite 2000
Matthews, NC 28105-1728
Phone (704) 302-8500
Other practice location 2
200 S College St
Suite 500
Charlotte, NC 28202-2012
Phone (704) 302-8800
Other practice location 3
10650 Park Rd
Suite 420
Charlotte, NC 28210-8538
Phone (704) 302-8700
Other practice location 4
15110 John J Delaney Dr
Suite 200
Charlotte, NC 28277-3544
Phone (704) 302-8100
Other practice location 5
11304 Hawthorne Dr
Suite 100
Mint Hill, NC 28227-9425
Phone (704) 545-6400
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2825 Lyndhurst Ave
Winston Salem, NC 27103-4146
3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200
416 E 36TH St
Suite 200
Charlotte, NC 28205-1030
Phone (980) 302-9820
5145 Sellers Rd
Shallotte, NC 28470-3405
Phone (910) 754-4572
Hospital & facility affiliations
- Novant Health Presbyterian Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolinas Medical Center | Current | Accepting new patients | |
| The Charlotte-Mecklenburg Hospital Authority | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Carolinas Medical Center | Current | Accepting new patients | |
| The Charlotte-Mecklenburg Hospital Authority | Current | Accepting new patients | |
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Past | Accepting new patients |
Locations
1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791
15110 John J Delaney Dr
Ste 200
Charlotte, NC 28277
Phone (704) 302-8100
416 E 36th St
Ste 200
Charlotte, NC 28205
Phone (980) 302-9800
10650 Park Rd
Ste 420
Charlotte, NC 28210
Phone (704) 302-8700
10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000
441 McAlister Rd
Ste 1200
Lincolnton, NC 28092
Phone (980) 212-6200
332 N Trade St
Ste 2000
Matthews, NC 28105
Phone (704) 302-8500
11304 Hawthorne Dr
Ste 100
Mint Hill, NC 28227
Phone (704) 384-8760
1550 Faulk St
Ste 1500
Monroe, NC 28112
Phone (704) 302-9700
5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441
2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300
Interoperability endpoints
- nwaltz1036245@direct.novanthealth.org
Organizations & group practices 13
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Neurology with Special Qualifications in Child Neurology Physician
- Charlotte, NC
- NPI 1366409492
-
- Obstetrics & Gynecology Physician
- Charlotte, NC
- NPI 1275774333
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Charlotte, NC
- NPI 1477878890
-
- Medical Oncology Physician
- Indian Land, SC
- NPI 1669738829
NC
-
- Endocrinology, Diabetes & Metabolism Physician
- Charlotte, NC
- NPI 1932457983
-
- Community/Retail Pharmacy
- Charlotte, NC
- NPI 1982710554
-
- Family Medicine Physician
- Mint Hill, NC
- NPI 1164724100
-
- Endocrinology, Diabetes & Metabolism Physician
- Charlotte, NC
- NPI 1437038544
-
- Cardiovascular Disease Physician
- Winston Salem, NC
- NPI 1023798931
-
- Obstetrics & Gynecology Physician
- Matthews, NC
- NPI 1386506137
-
- Urology Physician
- Lincolnton, NC
- NPI 1437459021
-
- Rehabilitation Hospital Unit
- Charlotte, NC
- NPI 1962987131
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Charlotte, NC
- NPI 1396798591
Hospital
-
- Psychiatric Hospital Unit
- Charlotte, NC
- NPI 1497708838
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1881647204
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670198400000",
"number": "1295995462",
"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": "416 E 36TH ST",
"address_2": "STE 200",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282051030",
"telephone_number": "980-302-9800",
"fax_number": "980-302-9810"
}
],
"practiceLocations": [
{
"address_1": "332 N Trade St",
"address_2": "Suite 2000",
"address_purpose": "LOCATION",
"city": "Matthews",
"state": "NC",
"postal_code": "281051728",
"country_code": "US",
"telephone_number": "704-302-8500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "200 S College St",
"address_2": "Suite 500",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282022012",
"country_code": "US",
"telephone_number": "704-302-8800",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "10650 Park Rd",
"address_2": "Suite 420",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282108538",
"country_code": "US",
"telephone_number": "704-302-8700",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "15110 John J Delaney Dr",
"address_2": "Suite 200",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282773544",
"country_code": "US",
"telephone_number": "704-302-8100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11304 Hawthorne Dr",
"address_2": "Suite 100",
"address_purpose": "LOCATION",
"city": "Mint Hill",
"state": "NC",
"postal_code": "282279425",
"country_code": "US",
"telephone_number": "704-545-6400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALTZ",
"first_name": "NICHOLE",
"middle_name": "ANN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-11",
"last_updated": "2022-12-05",
"certification_date": "2022-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-01323",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.