Individual provider Active NPI

Folashade Adebii Jose, MD

  • Pediatrics Physician
  • Concord, NC
National Provider Identifier
1346422912
Registry record updated Apr 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2010-01195 Issued in NC
Practice address
100 Medical Park Dr
Ste 310E
Concord, NC 28025-2948
Phone
(704) 403-2660
NPI assigned
Dec 5, 2007
Last updated
Apr 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2025

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 2010-01195 NC Primary
Pediatric Gastroenterology Physician 2080P0206X 2010-01195 NC

Addresses

Primary practice location

100 Medical Park Dr
Ste 310E
Concord, NC 28025-2948

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

101 E W T Harris Blvd
Bldg 3000 Ste 3301
Charlotte, NC 28262-3485
Phone (704) 403-2660

Other practice location 2

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

Other practice location 3

1781 Tate Blvd SE
Hickory, NC 28602-4251
Phone (704) 381-8840

Other practice location 4

2550 Court Dr
Gastonia, NC 28054-2152
Phone (704) 381-8840

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address fjose454570@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
I20100817001354 NC Practitioner - Pediatric MedicinePractitioner - Gastroenterology 4880731033 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010-01195NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center Pediatrics Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Pediatric Gastroenterology CurrentSince Feb 2, 2020 Accepting new patients
Carolinas Medical Center Pediatrics CurrentSince Jul 29, 2019 Accepting new patients
Carolinas Medical Center CurrentSince Jul 29, 2019 Accepting new patients
Carolinas Medical Center-Northeast Past Accepting new patients
Carolinas Medical Center-Northeast Pediatric Gastroenterology PastSince Sep 1, 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

100 Medical Park Dr
Ste 310E
Concord, NC 28025

Interoperability endpoints

  • Direct secure messaging: fjose454570@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 6

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": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743811200000",
    "number": "1346422912",
    "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": "100 MEDICAL PARK DR",
            "address_2": "STE 310E",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252948",
            "telephone_number": "704-403-2660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E W T Harris Blvd",
            "address_2": "Bldg 3000 Ste 3301",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623485",
            "country_code": "US",
            "telephone_number": "704-403-2660",
            "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": "1781 Tate Blvd SE",
            "address_purpose": "LOCATION",
            "city": "Hickory",
            "state": "NC",
            "postal_code": "286024251",
            "country_code": "US",
            "telephone_number": "704-381-8840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2550 Court Dr",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280542152",
            "country_code": "US",
            "telephone_number": "704-381-8840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSE",
        "first_name": "FOLASHADE",
        "middle_name": "ADEBII",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-05",
        "last_updated": "2025-04-05",
        "certification_date": "2025-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2010-01195",
            "primary": true
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NC",
            "license": "2010-01195",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fjose454570@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "100 Medical Park Dr",
            "address_2": "Ste 310E",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252948",
            "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 Concord, NC

Sources for this page

Verify at the official NPI Registry.