Individual provider Active NPI

Andreas Wallentin Magnusson, MD

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1457086233
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2025-01364 Issued in NC
Practice address
10320 Mallard Creek Rd Ste 271
Charlotte, NC 28262-5204
Phone
(704) 412-8297
Fax
(800) 973-2131
NPI assigned
Jul 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2025-01364 NC Primary

Addresses

Primary practice location

10320 Mallard Creek Rd Ste 271
Charlotte, NC 28262-5204

Mailing address

10320 Mallard Creek Rd Ste 271
Charlotte, NC 28262-5204
Phone (704) 412-8297

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
I20251002002063 NC Practitioner - Family Practice 9537540414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

530 Corporate Cir
Suite 200
Salisbury, NC 28147-8074
Phone (704) 638-0336

Hospital & facility affiliations

  • Novant Health Rowan Medical Center Hospital, Salisbury, NC, CCN 340015

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R12374IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Jul 28, 2025 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 28, 2025 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Magnusson Clinic PLLC Family Medicine Current Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

1035 Dale Earnhardt Blvd
Kannapolis, NC 28083
Phone (704) 316-1886

530 Corporate Cir
#200
Salisbury, NC 28147
Phone (704) 637-7590

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: amagnusson1728009@direct.novanthealth.org

Organizations & group practices 4

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 1

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": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1457086233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10320 MALLARD CREEK RD STE 271",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282625204",
            "telephone_number": "704-412-8297",
            "fax_number": "800-973-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10320 MALLARD CREEK RD STE 271",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282625204",
            "telephone_number": "704-412-8297",
            "fax_number": "800-973-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGNUSSON",
        "first_name": "ANDREAS",
        "middle_name": "WALLENTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-18",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2025-01364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.