NPIMap

Individual provider Active NPI

Madison Lucille Mayle

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1376387415
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone
(704) 446-5185
Fax
(704) 446-0221
NPI assigned
Jun 24, 2024
Last updated
Aug 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NC Primary

Addresses

Primary practice location

1000 Blythe Blvd
Charlotte, NC 28203-5812

Mailing address

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 446-5185

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
I20241203003229 NC Practitioner - Physician Assistant 7719412501 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

100 Medical Park Dr
Suite 210
Concord, NC 28025-2966
Phone (704) 403-6100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Sep 23, 2024 Accepting new patients
Carolinas Medical Center CurrentSince Sep 23, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 28, 2025 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Sep 23, 2024 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Sep 23, 2024 Accepting new patients
Carolinas Medical Center CurrentSince Sep 23, 2024 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Sep 23, 2024 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients

Locations

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

1025 Morehead Medical Dr
Ste 200
Charlotte, NC 28204
Phone (704) 302-8000

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

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

100 Medical Park Dr
Ste 210
Concord, NC 28025
Phone (704) 403-6100

2680 Aberdeen Blvd
Gastonia, NC 28054
Phone (704) 446-3222

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

Interoperability endpoints

  • Direct secure messaging: mmayle2781198@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 12

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 3

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": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1376387415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-446-5185",
            "fax_number": "704-446-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-446-5185",
            "fax_number": "704-446-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYLE",
        "first_name": "MADISON",
        "middle_name": "LUCILLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.