Individual provider Active NPI

Charles John Niemeyer Jr., PA-C

  • Physician Assistant
  • Gastonia, NC
National Provider Identifier
1376516369
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
102452 Issued in NC
Practice address
2345 Court Dr
Gastonia, NC 28054-2151
Phone
(704) 865-0077
Fax
(704) 867-6401
NPI assigned
Feb 9, 2006
Last updated
Mar 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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 102452 NC Primary

Addresses

Primary practice location

2345 Court Dr
Gastonia, NC 28054-2151

Mailing address

2345 Court Dr
Gastonia, NC 28054-2151
Phone (704) 865-0077

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050111000815 NC Practitioner - Physician Assistant 1153379623 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

2345 Court Dr
Gastonia, NC 28054-2151
Phone (704) 865-0077

2525 Court Dr
Gastonia, NC 28054-2140
Phone (704) 834-2450

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

660 Summit Crossing PL
Suite 301
Gastonia, NC 28054-2181
Phone (704) 854-8799

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Orthopaedic & Sports Medicine Center PA CurrentSince Aug 16, 2004 Accepting new patients
Carolina Orthopaedic & Sports Medicine Center PA CurrentSince Aug 16, 2004 Accepting new patients

Locations

2345 Court Dr
Gastonia, NC 28054
Phone (704) 833-3103

620 Summit Crossing Pl
Ste 108
Gastonia, NC 28054
Phone (704) 865-0077

Interoperability endpoints

  • Direct secure messaging: charles.niemeyerjrpa.p1@direct.cosmc.nextgenshare.com
  • Direct secure messaging: cniemeyerpac@cosmc1234.srs-direct.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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 1

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1376516369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 COURT DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542151",
            "telephone_number": "704-865-0077",
            "fax_number": "704-867-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 COURT DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542151",
            "telephone_number": "704-865-0077",
            "fax_number": "704-867-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMEYER",
        "first_name": "CHARLES",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.