Individual provider Active NPI

Peter Michael Giftos, M.D.

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1447246004
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20010038 Issued in NC
Practice address
2600 E 7TH St
Suite 100
Charlotte, NC 28204-4375
Phone
(704) 384-8800
Fax
(704) 384-8819
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 20010038 NC Primary

Addresses

Primary practice location

2600 E 7TH St
Suite 100
Charlotte, NC 28204-4375

Mailing address

1900 Randolph Rd
Suite 500
Charlotte, NC 28207-1122
Phone (704) 384-9113

Other identifiers 1

IdentifierTypeStateIssuer
891313MMedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pgiftos14484@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170606001648 NC Practitioner - Pediatric Medicine 4688815459 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20010038NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Pediatrics CurrentSince Mar 15, 2017 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Mar 15, 2017 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 15, 2023 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients

Locations

517 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 384-1406

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

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

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

Organizations & group practices 5

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1447246004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 RANDOLPH RD",
            "address_2": "SUITE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071122",
            "telephone_number": "704-384-9113",
            "fax_number": "704-316-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 E 7TH ST",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044375",
            "telephone_number": "704-384-8800",
            "fax_number": "704-384-8819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIFTOS",
        "first_name": "PETER",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "20010038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891313M",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pgiftos14484@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2600 E 7th St",
            "address_2": "Suite 100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282044375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.