NPIMap

Individual provider Active NPI

Cristine Mattis, ARNP-C

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1356583678
Registry record updated Apr 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
224739 Issued in NC
Practice address
10512 Park Rd
Suite # 113
Charlotte, NC 28210-8475
Phone
(704) 541-8207
Fax
(704) 540-8288
NPI assigned
Apr 1, 2009
Last updated
Apr 1, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 224739 NC Primary
Adult Health Nurse Practitioner 363LA2200X 2831582 FL

Addresses

Primary practice location

10512 Park Rd
Suite # 113
Charlotte, NC 28210-8475

Mailing address

PO Box 36488
Charlotte, NC 28236-6488
Phone (704) 248-3400

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
I20090609000677 NC Practitioner - Nurse Practitioner 3274683461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urology Specialists of the Carolinas PLLCGroup PAC ID 0648178020, 78 clinicians

Practice addresses (Care Compare)

10660 Park Rd
Suite 4100
Charlotte, NC 28210-8551
Phone (704) 541-8207

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2831582FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Specialists of the Carolinas CurrentSince May 26, 2024 Accepting new patients

Locations

10660 Park Rd
Ste 4100
Charlotte, NC 28210
Phone (704) 541-8207

Interoperability endpoints

  • Direct secure messaging: cmattis@urologyspecialistsnc.emadirect.md
  • Direct secure messaging: cmattis44614@direct.novanthealth.org

Organizations & group practices 2

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 6

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": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238544000000",
    "number": "1356583678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36488",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282366488",
            "telephone_number": "704-248-3400",
            "fax_number": "704-337-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10512 PARK RD",
            "address_2": "SUITE # 113",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108475",
            "telephone_number": "704-541-8207",
            "fax_number": "704-540-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTIS",
        "first_name": "CRISTINE",
        "credential": "ARNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-01",
        "last_updated": "2009-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "224739",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "2831582",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.