Individual provider Active NPI

Shannon Nicole Dobbins

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1407223712
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5013467 Issued in NC
Practice address
125 Queens Rd Ste 200
Charlotte, NC 28204-3215
Phone
(704) 343-9800
Fax
(704) 347-2011
NPI assigned
Aug 24, 2015
Last updated
Jul 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00609000 NJ
Nurse Practitioner 363L00000X 5013467 NC Primary

Addresses

Primary practice location

125 Queens Rd Ste 200
Charlotte, NC 28204-3215

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 343-9800

Other practice location 1

9 Sturbridge Ct
Egg Harbor Township, NJ 08234-7643
Phone (609) 788-0553

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sdobbins835269@direct.novanthealth.org

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
I20201021001394 NC Practitioner - Nurse Practitioner 0446530653 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Presbyterian HospitalGroup PAC ID 1153231907, 412 clinicians
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

125 Queens Rd
Charlotte, NC 28204-3215

1401 Matthews Township Pkwy
Suite 110
Matthews, NC 28105-5403
Phone (704) 264-3500

1401 Matthews Township Pkwy
Suite 212And312
Matthews, NC 28105-5402
Phone (704) 316-3131

1640 E Roosevelt Blvd
Monroe, NC 28112-4017
Phone (704) 226-0500

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-9073

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Presbyterian Hospital Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Oct 16, 2020 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Oct 16, 2020 Accepting new patients
The Presbyterian Hospital CurrentSince Oct 16, 2020 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Oct 16, 2020 Accepting new patients
The Presbyterian Hospital CurrentSince Oct 16, 2020 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

125 Baldwin Ave
Ste 200
Charlotte, NC 28204
Phone (704) 384-5043

125 Queens Rd
Ste 200
Charlotte, NC 28204

125 Queens Rd
Ste 330
Charlotte, NC 28204
Phone (704) 384-5043

301 Hawthorne Ln
Ste 200
Charlotte, NC 28204
Phone (704) 316-5100

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

8201 Healthcare Loop
Ste 201
Charlotte, NC 28215
Phone (704) 316-3024

1401 Matthews Township Pkwy
Ste 212312
Matthews, NC 28105
Phone (704) 316-3131

134 Medical Park Rd
Ste 200
Mooresville, NC 28117
Phone (704) 384-7972

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: sdobbins835269@direct.novanthealth.org

Organizations & group practices 9

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 5

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": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1407223712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-343-9800",
            "fax_number": "704-347-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043215",
            "telephone_number": "704-343-9800",
            "fax_number": "704-347-2011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9 Sturbridge Ct",
            "address_purpose": "LOCATION",
            "city": "Egg Harbor Township",
            "state": "NJ",
            "postal_code": "082347643",
            "country_code": "US",
            "telephone_number": "609-788-0553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOBBINS",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00609000",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5013467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdobbins835269@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "125 Queens Rd Ste 200",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.