Payton Gregory Fennell, D.O

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

200601317 Issued in NC

Practice address

4741 Randolph Rd
Charlotte, NC 28211-2919

Phone

(704) 365-6730

Fax

(704) 365-6731

NPI assigned

Dec 11, 2006

Last updated

Jun 14, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC, GA2 enrollments

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 2

Specialty

Sports MedicineAlso: Family Practice

Education

Philadelphia College of Osteopathic Medicine, 2005

Medicare assignment

May accept Medicare assignment

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Comprehab, IncGroup PAC ID 2769653757, 376 clinicians

Cora South Carolina LLCGroup PAC ID 3173766334, shared by 6 NPIs, 220 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
• Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
• Novant Health Mint Hill Medical Center Hospital, Charlotte, NC, CCN 340190
• Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• Direct secure messaging: pfennell886293@direct.novanthealth.org

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.

• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group NPD
• DLP Frye Medical Group LLC

  dba FryeCare Lincolnton Medical Group

  • Rural Health Clinic/Center
  • Lincolnton, NC
  • NPI 1154005965
  Medicare reassignment NPD
• The Carolinas Emergency Group, PLLC

  • Emergency Medicine Physician
  • Dunn, NC
  • NPI 1477508836
  Medicare reassignment NPD
• Western Carolina Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Albemarle, NC
  • NPI 1134391758
  Medicare reassignment NPD
• Nes Georgia, Inc.

  • Emergency Medicine Physician
  • Hazlehurst, GA
  • NPI 1144201559
  Medicare reassignment NPD
• Comprehab LLC

  dba Compleat KiDZ Pediatric Therapy

  • Physical Therapist
  • Gastonia, NC
  • NPI 1407932775
  Care Compare group
• DLP Frye Medical Group LLC

  dba FryeCare Family Practice Hickory

  • Family Medicine Physician
  • Hickory, NC
  • NPI 1427597111
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Palliative Care

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Huntersville, NC
  • NPI 1679903017

  Family Medicine

  NPD
• Nes Georgia Inc

  • Emergency Medicine Physician
  • Newark, NJ
  • NPI 1912411331
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Dermatology

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1205481009
  NPD (past)
• Dodge County Emergency Physicians LLC

  • Emergency Medicine Physician
  • Eastman, GA
  • NPI 1811176795
  NPD (past)

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

• Novant Health Matthews Medical Center LLC

  dba Novant Health Matthews Medical Center

  • General Acute Care Hospital
  • Matthews, NC
  • NPI 1063463156
  Care Compare affiliation
• Novant Health Mint Hill Medical Center, LLC

  dba Novant Health Mint Hill Medical Center

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1972001469
  Care Compare affiliation
• The Presbyterian Hospital

  dba Novant Health Huntersville Medical Center

  • General Acute Care Hospital
  • Huntersville, NC
  • NPI 1346291309
  Care Compare affiliation
• The Presbyterian Hospital

  dba Presbyterian ESRD Unit

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1396798591

  Hospital

  Care Compare affiliation
• The Presbyterian Hospital

  dba Presbyterian Behavioral Health Unit

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1497708838
  Care Compare affiliation
• The Presbyterian Hospital

  dba Novant Health Presbyterian Medical Center

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1881647204
  Care Compare affiliation
• The Presbyterian Hospital

  dba Novant Health Presbyterian Medical Center - Skilled Nursing Unit

  • Skilled Nursing Facility
  • Charlotte, NC
  • NPI 1891871901

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1306906086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 12TH AVE NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286012798",
            "telephone_number": "828-485-3004",
            "fax_number": "828-328-4049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4741 RANDOLPH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112919",
            "telephone_number": "704-365-6730",
            "fax_number": "704-365-6731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5641 Poplar Tent Rd",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280277533",
            "country_code": "US",
            "telephone_number": "704-782-1955",
            "fax_number": "704-792-3903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "52 12th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Hickory",
            "state": "NC",
            "postal_code": "28601",
            "country_code": "US",
            "telephone_number": "828-485-3004",
            "fax_number": "828-328-4049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FENNELL",
        "first_name": "PAYTON",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200601317",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NC",
            "license": "200601317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pfennell886293@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "4741 Randolph Rd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282112919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth Fenichel, DMD
• Tsehaiwork Tesfaye Fenikile, MD
• Carly Fenimore, M.S., R.D., L.D.N.
• Fenix Collective Inc
• Sharon Ann Fenlon I
• Teresa Fatemah Fennell, MS LCSWA
• Elizabeth Fenner, M.A.
• Gail Herndon Fennimore, PT
• Sydney Kay Fenton, DC
• Helen Elizabeth Fentress, LMFTA

• Sports Medicine (Family Medicine) Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Sports Medicine (Family Medicine) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.

Verify at the official NPI Registry.