Individual provider Active NPI

Michael Balfour Livingston, MD

  • Medical Oncology Physician
  • Charlotte, NC
National Provider Identifier
1396769618
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
33703 Issued in NC
Practice address
15830 Ballantyne Medical PL
Ste 200
Charlotte, NC 28277-4653
Phone
(980) 442-9600
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 33703 NC
Hematology & Oncology Physician 207RH0003X 33703 NC
Medical Oncology Physician 207RX0202X 33703 NC Primary

Addresses

Primary practice location

15830 Ballantyne Medical PL
Ste 200
Charlotte, NC 28277-4653

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

16455 Statesville Rd
Ste 280
Huntersville, NC 28078-7135
Phone (980) 442-4600

Other practice location 2

1021 Morehead Medical Dr
Ste A
Charlotte, NC 28204-2990
Phone (980) 442-2000

Other practice location 3

2610 Aberdeen Blvd
Gastonia, NC 28054-0637
Phone (980) 442-4500

Other practice location 4

10660 Park Rd
Ste 2100
Charlotte, NC 28210-8413
Phone (980) 442-0410

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mlivingston137120@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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070226000232 NC Practitioner - Medical OncologyPractitioner - Internal MedicinePractitioner - Hematology/Oncology 3870695653 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33703NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte-Mecklenburg Hospital Authority CurrentSince Dec 1, 2013 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Dec 1, 2013 Accepting new patients

Locations

10660 Park Rd
Ste 2100
Charlotte, NC 28210
Phone (980) 442-0410

15830 Ballantyne Medical Pl
Ste 200
Charlotte, NC 28277
Phone (980) 442-9600

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

1001 Blythe Blvd
Ste 500
Charlotte, NC 28203
Phone (704) 355-5100

1021 Morehead Medical Dr
Ste A
Charlotte, NC 28204
Phone (704) 355-2884

1100 S Tryon St
Ste 400
Charlotte, NC 28203
Phone (704) 446-4000

2610 Aberdeen Blvd
Gastonia, NC 28054
Phone (704) 865-5210

16455 Statesville Rd
Ste 280
Huntersville, NC 28078
Phone (704) 295-3600

600 Hospital Dr
Monroe, NC 28112
Phone (704) 283-3100

Interoperability endpoints

  • Direct secure messaging: mlivingston137120@carolinashealthcaresystem.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1396769618",
    "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": "15830 BALLANTYNE MEDICAL PL",
            "address_2": "STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774653",
            "telephone_number": "980-442-9600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16455 Statesville Rd",
            "address_2": "Ste 280",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787135",
            "country_code": "US",
            "telephone_number": "980-442-4600",
            "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"
        },
        {
            "address_1": "2610 Aberdeen Blvd",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280540637",
            "country_code": "US",
            "telephone_number": "980-442-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10660 Park Rd",
            "address_2": "Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108413",
            "country_code": "US",
            "telephone_number": "980-442-0410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIVINGSTON",
        "first_name": "MICHAEL",
        "middle_name": "BALFOUR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "33703",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "33703",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NC",
            "license": "33703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlivingston137120@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "15830 Ballantyne Medical Pl",
            "address_2": "Ste 200",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282774653",
            "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.