Active NPI
Mark Thomas Emery, M.D.
- Otolaryngology Physician
- Salisbury, NC
National Provider Identifier
1366443509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 104310
- Practice address
- 330 Jake Alexander Blvd W
Suite 101
Salisbury, NC 28147-1384 - Phone
- (704) 637-5668
- Fax
- (704) 637-5605
- NPI assigned
- Aug 10, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 104310 | NC | Primary |
| Specialist | 174400000X | 200100352 | NC |
Addresses
Primary practice location
330 Jake Alexander Blvd W
Suite 101
Salisbury, NC 28147-1384
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 637-5668
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89129KJ | Medicaid | NC |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | memery117665@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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111207000566 | NC | Practitioner - Otolaryngology | 9335138759 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Brody School of Medicine at East Carolina University, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- ENT Carolina PA
Practice addresses (Care Compare)
2520 Aberdeen Blvd
Gastonia, NC 28054-0635
Phone (704) 868-8400
Hospital & facility affiliations
- Caromont Regional Medical Center
- Carolinas Medical Center/Behav Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200100352 | NC | MD | Specialist |
| 104310 | NC | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| ENT Carolina PA | Specialist | Current | Accepting new patients |
Locations
209 Park St
Belmont, NC 28012
Phone (704) 323-3337
209 Park St
Ste 500
Belmont, NC 28012
Phone (704) 341-9600
2520 Aberdeen Blvd
Gastonia, NC 28054
Phone (704) 868-8400
Interoperability endpoints
- memery2884133@carolinashealthcaresystem.direct-ci.com
- memery117665@direct.novanthealth.org
Organizations & group practices 1
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 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Charlotte, NC
- NPI 1720029705
Hospital
-
- General Acute Care Hospital
- Gastonia, NC
- NPI 1013918960
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603584000000",
"number": "1366443509",
"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",
"telephone_number": "704-637-5668",
"fax_number": "704-637-5605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 JAKE ALEXANDER BLVD W",
"address_2": "SUITE 101",
"city": "SALISBURY",
"state": "NC",
"postal_code": "281471384",
"telephone_number": "704-637-5668",
"fax_number": "704-637-5605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMERY",
"first_name": "MARK",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-10",
"last_updated": "2020-10-25",
"certification_date": "2020-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NC",
"license": "104310",
"primary": true
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NC",
"license": "200100352",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89129KJ",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "memery117665@direct.novanthealth.org",
"affiliation": "N",
"address_1": "330 Jake Alexander Blvd W",
"address_2": "Suite 101",
"city": "Salisbury",
"state": "NC",
"country_code": "US",
"postal_code": "281471384",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Salisbury, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2020; 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.