Individual provider Active NPI

Emma Rebecca Segal, MD

  • Pediatrics Physician
  • Matthews, NC
National Provider Identifier
1467013250
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2022-01855 Issued in NC
Practice address
1401 Matthews Township Pkwy Ste 100
Matthews, NC 28105-5403
Phone
(704) 384-1080
NPI assigned
Jun 24, 2019
Last updated
Aug 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X LL82870 SC
Pediatrics Physician 208000000X 2022-01855 NC Primary

Addresses

Primary practice location

1401 Matthews Township Pkwy Ste 100
Matthews, NC 28105-5403

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

Children's Hospital Outpatient Center
14 Medical Park, Ste 400
Columbia, SC 29203
Phone (803) 434-6155

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
I20230817001064 NC Practitioner - Pediatric Medicine 6709218654 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 30, 2023 Accepting new patients
Novant Health Medical Group LLC Pediatrics CurrentSince May 30, 2023 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

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

1401 Matthews Township Pkwy
Ste 100
Matthews, NC 28105
Phone (704) 384-1080

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

Interoperability endpoints

  • Direct secure messaging: esegal1066686@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1467013250",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MATTHEWS TOWNSHIP PKWY STE 100",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055403",
            "telephone_number": "704-384-1080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Children's Hospital Outpatient Center",
            "address_2": "14 Medical Park, Ste 400",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "29203",
            "country_code": "US",
            "telephone_number": "803-434-6155",
            "fax_number": "803-434-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEGAL",
        "first_name": "EMMA",
        "middle_name": "REBECCA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "LL82870",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2022-01855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.