Jerome Nymberg III, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

27498 Issued in NC

Practice address

270 Copperfield Blvd NE
Ste 102
Concord, NC 28025-2441

Phone

(704) 786-6521

NPI assigned

Oct 6, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ambulatory@direct.carolinashealthcare.org
• FHIR API: https://fhir-myrecord.cerner.com/r4/c32cb33f-ec61-4f25-9140-0b9b174fe4db/

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.

• Carolinas Physicians Network Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Charlotte, NC
  • NPI 1477878890
  Medicare reassignment NPD
• Carolinas Physicians Network Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1437038544
  NPD
• Carolinas Physicians Network Inc

  • Family Medicine Physician
  • Kannapolis, NC
  • NPI 1518197458
  NPD
• Cabarrus Family Medicine

  • Primary Care Clinic/Center
  • Concord, NC
  • NPI 1679758759
  NPD (past)

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1447248208",
    "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": "270 COPPERFIELD BLVD NE",
            "address_2": "STE 102",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252441",
            "telephone_number": "704-786-6521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5641 Poplar Tent Rd",
            "address_2": "Ste 101",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280277533",
            "country_code": "US",
            "telephone_number": "704-782-1955",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4315 Physicians Blvd",
            "address_2": "STE 101",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "NC",
            "postal_code": "280757430",
            "country_code": "US",
            "telephone_number": "704-455-6521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8560 Cook St",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "NC",
            "postal_code": "281247686",
            "country_code": "US",
            "telephone_number": "704-436-6521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4949 Professional Park Dr",
            "address_2": "Ste 101",
            "address_purpose": "LOCATION",
            "city": "Kannapolis",
            "state": "NC",
            "postal_code": "280818637",
            "country_code": "US",
            "telephone_number": "704-938-6521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYMBERG",
        "first_name": "JEROME",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "27498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ambulatory@direct.carolinashealthcare.org",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "270 Copperfield Blvd NE",
            "address_2": "Ste 102",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Onyemaechi Nwanaji-Enwerem
• Joy Ulongozi Nwogwugwu, PMHNP
• Nkwachioma Ugwuezi Nwosu, PMHNP-BC
• Charlie Nyland
• Jane Elizabeth Nymberg, CRNA
• Rosemary Chigozie Nze-Henry, NP
• O'Brien and West DMD, IX, PLLC
• Elizabeth T O'Brien, NP
• Stephen Joseph O'Brien, MD
• Michael John O'Connell, DO

• Family Medicine Physician in Concord, NC
• Providers in Concord, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.