Individual provider Active NPI

Guillaume Sylvain Chevrollier, MD

  • Colon & Rectal Surgery Physician
  • Charlotte, NC
National Provider Identifier
1306265228
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
2021-02226 Issued in NC
Practice address
1718 E 4TH St Ste 307
Charlotte, NC 28204-3283
Phone
(704) 333-1259
Fax
(704) 333-0371
NPI assigned
Apr 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2021-02226 NC
Student in an Organized Health Care Education/Training Program 390200000X
Colon & Rectal Surgery Physician 208C00000X 2021-02226 NC Primary

Addresses

Primary practice location

1718 E 4TH St Ste 307
Charlotte, NC 28204-3283

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

1015 Walnut St
Curtis Building, Suite 620
Philadelphia, PA 19107-5005
Phone (215) 955-6864

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gchevrollier896888@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210804001013 NC Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 4284858390 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Presbyterian HospitalGroup PAC ID 1153231907, 412 clinicians
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

125 Queens Rd
Suite 430
Charlotte, NC 28204-3579
Phone (980) 302-6700

1718 E 4TH St
Suite 307
Charlotte, NC 28204-3283
Phone (704) 333-1259

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy31
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021-02226NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Presbyterian Hospital CurrentSince Aug 13, 2021 Accepting new patients
The Presbyterian Hospital Surgery CurrentSince Aug 13, 2021 Accepting new patients
The Presbyterian Hospital Current Accepting new patients
Novant Health Medical Group, LLC Surgery CurrentSince Aug 13, 2021 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 13, 2021 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

125 Queens Rd
Ste 430
Charlotte, NC 28204
Phone (980) 302-6300

125 Queens Rd
Ste 560
Charlotte, NC 28204
Phone (980) 302-6270

330 Billingsley Rd
Ste 202
Charlotte, NC 28211
Phone (704) 316-2350

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

1718 E 4th St
Ste 307
Charlotte, NC 28204
Phone (704) 333-1259

125 Queens Rd
Charlotte, NC 28204
Phone (980) 302-6380

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

14330 Oakhill Park Ln
Ste 140
Huntersville, NC 28078
Phone (704) 316-3492

9930 Kincey Ave
Ste 210
Huntersville, NC 28078
Phone (704) 316-3492

1450 Matthews Township Pkwy
Ste 230
Matthews, NC 28105
Phone (704) 384-8615

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 7

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1306265228",
    "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": "1718 E 4TH ST STE 307",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043283",
            "telephone_number": "704-333-1259",
            "fax_number": "704-333-0371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1015 Walnut St",
            "address_2": "Curtis Building, Suite 620",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191075005",
            "country_code": "US",
            "telephone_number": "215-955-6864",
            "fax_number": "215-955-2878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEVROLLIER",
        "first_name": "GUILLAUME",
        "middle_name": "SYLVAIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-08",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2021-02226",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NC",
            "license": "2021-02226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gchevrollier896888@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1718 E 4th St Ste 307",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.