NPIMap

Individual provider Active NPI

Douglas Sou Chen, MD

  • Family Medicine Physician
  • Indian Trail, NC
National Provider Identifier
1306860580
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9801202 Issued in NC
Practice address
6066 W Highway 74
Indian Trail, NC 28079-3591
Phone
(980) 993-7150
NPI assigned
Jul 27, 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9801202 NC Primary

Addresses

Primary practice location

6066 W Highway 74
Indian Trail, NC 28079-3591

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

2301 US Highway 74 W
Wadesboro, NC 28170-7554
Phone (704) 994-4900

Other practice location 2

12016 Lemmond Farm Dr
Ste 200
Charlotte, NC 28227-8353
Phone (704) 863-0600

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address dchen128461@CarolinasHealthcareSystem.direct-ci.com Atrium Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110209000474 NC Practitioner - Family Practice 8729268669 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Georgetown University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

14214 Ballantyne Lake Rd
Charlotte, NC 28277-3373

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Oct 1, 2012 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 1, 2012 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Family Medicine CurrentSince Jan 1, 2019 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jan 1, 2019 Accepting new patients
Anson Regional Medical Services, Inc. Past Accepting new patients
Union Physicians Network Inc Past Accepting new patients
Carolinas Physicians Network, Inc Family Medicine Past Accepting new patients
Anson Regional Medical Services, Inc. Family Medicine Past Accepting new patients

Locations

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

12016 Lemmond Farm Dr
#200
Charlotte, NC 28227
Phone (704) 863-0600

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

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

6030 W Highway 74
Ste D
Indian Trail, NC 28079
Phone (704) 226-0413

6066 W Highway 74
Indian Trail, NC 28079
Phone (980) 993-7150

6208 Creft Cir
Ste 222
Indian Trail, NC 28079
Phone (704) 882-1666

2301 US Highway 74 W
Wadesboro, NC 28170
Phone (704) 694-5131

Interoperability endpoints

  • Direct secure messaging: dchen128461@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 10

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.

Hospital & facility affiliations 10

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1306860580",
    "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": "6066 W HIGHWAY 74",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280793591",
            "telephone_number": "980-993-7150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 US Highway 74 W",
            "address_purpose": "LOCATION",
            "city": "Wadesboro",
            "state": "NC",
            "postal_code": "281707554",
            "country_code": "US",
            "telephone_number": "704-994-4900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12016 Lemmond Farm Dr",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282278353",
            "country_code": "US",
            "telephone_number": "704-863-0600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "DOUGLAS",
        "middle_name": "SOU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9801202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "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"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dchen128461@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "6066 W Highway 74",
            "city": "Indian Trail",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280793591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indian Trail, NC

Sources for this page

Verify at the official NPI Registry.