NPIMap

Individual provider Active NPI

Padideh Rezabakhshpour, FNP

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1376299750
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5015842 Issued in NC
Practice address
400 E Morehead St
Ste 202
Charlotte, NC 28202-2610
Phone
(704) 355-0607
NPI assigned
Feb 24, 2022
Sex
Female
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5015842 NC
Family Nurse Practitioner 363LF0000X 5015842 NC Primary

Addresses

Primary practice location

400 E Morehead St
Ste 202
Charlotte, NC 28202-2610

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

3311 Beam Rd
Ste 300
Charlotte, NC 28217-9422
Phone (704) 468-0135

Other practice location 2

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

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address prezabakhshpour451448@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220519002350 NC Practitioner - Nurse Practitioner 3577940121 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
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
Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians

Practice addresses (Care Compare)

Charlotte, NC 28217
Phone (704) 468-0135

400 E Morehead St
Suite 202
Charlotte, NC 28202-2610
Phone (704) 355-0607

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jun 5, 2022 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Aug 23, 2022 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Medical Center CurrentSince Feb 26, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Aug 23, 2022 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Pathology Group, PA Current Accepting new patients
Charlotte-Mecklenburg Hospital Authority CurrentSince Jun 5, 2022 Accepting new patients
Carolinas Medical Center CurrentSince Feb 26, 2024 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Past Accepting new patients

Locations

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

400 E Morehead St
#202
Charlotte, NC 28202
Phone (704) 355-0607

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

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

3311 Beam Rd
Ste 300
Charlotte, NC 28217
Phone (704) 468-0135

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

Interoperability endpoints

  • Direct secure messaging: prezabakhshpour451448@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 11

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 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": "1645660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1376299750",
    "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": "400 E MOREHEAD ST",
            "address_2": "STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022610",
            "telephone_number": "704-355-0607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3311 Beam Rd",
            "address_2": "Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282179422",
            "country_code": "US",
            "telephone_number": "704-468-0135",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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"
        }
    ],
    "basic": {
        "last_name": "REZABAKHSHPOUR",
        "first_name": "PADIDEH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-24",
        "last_updated": "2024-07-15",
        "certification_date": "2022-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5015842",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5015842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "prezabakhshpour451448@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "400 E Morehead St",
            "address_2": "Ste 202",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282022610",
            "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 Charlotte, NC

Sources for this page

Verify at the official NPI Registry.