Individual provider Active NPI

Paul Melvin Henson III, MD

  • Sports Medicine (Family Medicine) Physician
  • Huntersville, NC
National Provider Identifier
1396270740
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
2020-02758 Issued in NC
Practice address
16645 Birkdale Commons Pkwy
Ste 100a
Huntersville, NC 28078-5669
Phone
(704) 863-4878
NPI assigned
Apr 24, 2017
Sex
Male
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
Family Medicine Physician 207Q00000X 2020-02758 NC
Sports Medicine (Family Medicine) Physician 207QS0010X 2020-02758 NC Primary

Addresses

Primary practice location

16645 Birkdale Commons Pkwy
Ste 100a
Huntersville, NC 28078-5669

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

9726 Sam Furr Rd
Huntersville, NC 28078-8218
Phone (704) 863-4878

Other practice location 2

14214 Ballantyne Lake Rd
Ste 150
Charlotte, NC 28277-3372
Phone (704) 863-4878

Other practice location 3

5735 Prosperity Crossing Dr
Ste 2100
Charlotte, NC 28269-1360
Phone (704) 863-4878

Other practice location 4

5651 Poplar Tent Rd
Ste 102
Concord, NC 28027-7686
Phone (704) 863-4878

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address phenson496478@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, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210527001719 NC Practitioner - Family Practice 0446521892 Reassigns benefits to 3 organizations
I20211124002162 SC Practitioner - Family Practice 0446521892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas Tech University Health Science Center School of Medicine, 2017
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, shared by 56 NPIs, 2,324 clinicians
Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

1201 Colonial Commons CT
Lancaster, SC 29720-2210
Phone (803) 286-8443

201 McCullough Dr
Charlotte, NC 28262-3577
Phone (704) 547-1129

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

319 Penny LN
Concord, NC 28025-1221
Phone (704) 786-7158

5641 Poplar Tent Rd
Suite 101
Concord, NC 28027-7570
Phone (704) 782-1955

7482 Waterside Crossing Blvd
Denver, NC 28037-3006
Phone (704) 827-0598

Hospital & facility affiliations

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2020-02758NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Oct 2, 2021 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Family Medicine CurrentSince Jun 7, 2021 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Atrium Health North Market Network LLC Family Medicine CurrentSince Feb 5, 2025 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jun 7, 2021 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Family Medicine CurrentSince Jun 7, 2021 Accepting new patients
Carolinas Physicians Network Inc Family Medicine Past Accepting new patients

Locations

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

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

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

5735 Prosperity Crossing Dr
Ste 2100
Charlotte, NC 28269

14214 Ballantyne Lake Rd
Ste 150
Charlotte, NC 28277
Phone (704) 373-1813

4525 Cameron Valley Pkwy
Ste 4100D
Charlotte, NC 28211
Phone (704) 801-7310

5641 Poplar Tent Rd
Ste 101
Concord, NC 28027
Phone (704) 782-1955

319 Penny Ln
Concord, NC 28025
Phone (704) 262-1911

5651 Poplar Tent Rd
Ste 102
Concord, NC 28027
Phone (704) 782-4878

270 Copperfield Blvd NE
Ste 102
Concord, NC 28025
Phone (704) 721-2060

16645 Birkdale Commons Pkwy
Ste 100
Huntersville, NC 28078
Phone (704) 801-7390

9726 Sam Furr Rd
Huntersville, NC 28078
Phone (704) 801-3310

16645 Birkdale Commons Pkwy
Ste 100A
Huntersville, NC 28078

8560 Cook St
Mt Pleasant, NC 28124
Phone (704) 403-1911

704 Gold Hill Rd
Ste 203
Fort Mill, SC 29715
Phone (803) 835-0405

1201 Colonial Commons Ct
Lancaster, SC 29720
Phone (803) 286-8443

134 Professional Park Dr
Rock Hill, SC 29732
Phone (803) 329-3130

Interoperability endpoints

  • Direct secure messaging: phenson496478@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 7

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": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1396270740",
    "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": "16645 BIRKDALE COMMONS PKWY",
            "address_2": "STE 100A",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785669",
            "telephone_number": "704-863-4878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9726 Sam Furr Rd",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280788218",
            "country_code": "US",
            "telephone_number": "704-863-4878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14214 Ballantyne Lake Rd",
            "address_2": "Ste 150",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773372",
            "country_code": "US",
            "telephone_number": "704-863-4878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5735 Prosperity Crossing Dr",
            "address_2": "STE 2100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282691360",
            "country_code": "US",
            "telephone_number": "704-863-4878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5651 Poplar Tent Rd",
            "address_2": "Ste 102",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280277686",
            "country_code": "US",
            "telephone_number": "704-863-4878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENSON",
        "first_name": "PAUL",
        "middle_name": "MELVIN",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-24",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2020-02758",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NC",
            "license": "2020-02758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "phenson496478@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "16645 Birkdale Commons Pkwy",
            "address_2": "Ste 100A",
            "city": "Huntersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280785669",
            "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 Huntersville, NC

Sources for this page

Verify at the official NPI Registry.