Active NPI
Misty Eller, NP
- Nurse Practitioner
- Charlotte, NC
National Provider Identifier
1386839264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5004035
- Practice address
- 1025 Morehead Medical Dr
Ste 300
Charlotte, NC 28204-2963 - Phone
- (704) 355-1813
- NPI assigned
- Sep 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5004035 | NC | Primary |
Addresses
Primary practice location
1025 Morehead Medical Dr
Ste 300
Charlotte, NC 28204-2963
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Other practice location 1
1025 Morehead Medical Dr
Suite 600
Charlotte, NC 28204-2963
Phone (704) 355-8816
Other practice location 2
1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-1255
Other practice location 3
100 Medical Park Dr
Ste 110
Concord, NC 28025-2948
Phone (704) 403-1370
Other practice location 4
1021 Morehead Medical Dr
Ste A
Charlotte, NC 28204-2990
Phone (980) 442-2000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Ambulatory@direct.carolinashealthcare.org | Atrium Health |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Interoperability endpoints
- mbarrier402372@carolinashealthcaresystem.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632700800000",
"number": "1386839264",
"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": "1025 MOREHEAD MEDICAL DR",
"address_2": "STE 300",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282042963",
"telephone_number": "704-355-1813"
}
],
"practiceLocations": [
{
"address_1": "1025 Morehead Medical Dr",
"address_2": "Suite 600",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282042963",
"country_code": "US",
"telephone_number": "704-355-8816",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1350 S Kings Dr",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282072134",
"country_code": "US",
"telephone_number": "704-446-1255",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "100 Medical Park Dr",
"address_2": "STE 110",
"address_purpose": "LOCATION",
"city": "Concord",
"state": "NC",
"postal_code": "280252948",
"country_code": "US",
"telephone_number": "704-403-1370",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1021 Morehead Medical Dr",
"address_2": "Ste A",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282042990",
"country_code": "US",
"telephone_number": "980-442-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ELLER",
"first_name": "MISTY",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-13",
"last_updated": "2021-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "5004035",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Ambulatory@direct.carolinashealthcare.org",
"affiliation": "Y",
"affiliationName": "Atrium Health",
"address_1": "1025 Morehead Medical Dr",
"address_2": "Ste 300",
"city": "Charlotte",
"state": "NC",
"country_code": "US",
"postal_code": "282042963",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.