NPIMap

Individual provider Active NPI

Christopher Paul Stavenger, PA

  • Physician Assistant
  • Concord, NC
National Provider Identifier
1447337126
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-04943 Issued in NC
Practice address
1090 NE Gateway CT NE
Ste 204
Concord, NC 28025-2414
Phone
(704) 403-7020
NPI assigned
Nov 1, 2006
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-04943 NC Primary

Addresses

Primary practice location

1090 NE Gateway CT NE
Ste 204
Concord, NC 28025-2414

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

5651 Poplar Tent Rd
Ste 200
Concord, NC 28027-7686
Phone (704) 403-7020

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cstavenger454203@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150316002215 NC Practitioner - Physician Assistant 9234138736 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 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)

1085 NE Gateway CT NE
Suite 290
Concord, NC 28025-2412
Phone (704) 403-4650

1090 NE Gateway CT NE
Concord, NC 28025-2423

1090 NE Gateway CT NE
Concord, NC 28025-2927
Phone (704) 403-1311

200 Medical Park Dr
Concord, NC 28025-0933

236 Lephillip Court
Concord, NC 28025-1917
Phone (419) 221-6717

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

320 Jake Alexander Blvd W
Salisbury, NC 28147-1442
Phone (704) 636-0052

5651 Poplar Tent Rd
Suite 200
Concord, NC 28027-7530
Phone (704) 403-7020

6604 Roberta Rd
Harrisburg, NC 28075-9532
Phone (419) 221-6717

920 Church N St
Concord, NC 28025-2927
Phone (704) 403-3000

920 Church St N
Concord, NC 28025-2927
Phone (704) 403-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
943MNMDFoot & Ankle Surgery Podiatrist
10225MNMDSpeech-Language Pathologist
0010-04943NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Surgical Specialties, LLC CurrentSince Feb 9, 2015 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Aug 2, 2024 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jul 1, 2016 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Aug 2, 2024 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jul 1, 2016 Accepting new patients

Locations

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

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

5651 Poplar Tent Rd
Ste 200
Concord, NC 28027
Phone (704) 403-2275

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

1090 NE Gateway Ct NE
Ste 204
Concord, NC 28025
Phone (704) 403-7020

1090 NE Gateway Ct NE
Concord, NC 28025
Phone (704) 403-1311

1085 NE Gateway Ct NE
#200A
Concord, NC 28025
Phone (704) 403-8650

Interoperability endpoints

  • Direct secure messaging: cstavenger454203@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 8

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 8

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1447337126",
    "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": "1090 NE GATEWAY CT NE",
            "address_2": "STE 204",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252414",
            "telephone_number": "704-403-7020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5651 Poplar Tent Rd",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280277686",
            "country_code": "US",
            "telephone_number": "704-403-7020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAVENGER",
        "first_name": "CHRISTOPHER",
        "middle_name": "PAUL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cstavenger454203@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1090 NE Gateway Ct NE",
            "address_2": "Ste 204",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252414",
            "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 Concord, NC

Sources for this page

Verify at the official NPI Registry.