NPIMap

Individual provider Active NPI

John Matthew McDonald

  • Gynecologic Oncology Physician
  • Charlotte, NC
National Provider Identifier
1467496869
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
9801384 Issued in NC
Practice address
125 Queens Rd Ste 540
Charlotte, NC 28204-3215
Phone
(980) 302-6560
Fax
(980) 302-6565
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 39349 KY
Gynecologic Oncology Physician 207VX0201X 9801384 NC Primary

Addresses

Primary practice location

125 Queens Rd Ste 540
Charlotte, NC 28204-3215

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other identifiers 2

IdentifierTypeStateIssuer
64102924MedicaidKY
5909347MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmcdonald15714@direct.novanthealth.org

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
I20080919000390 NC Practitioner - Gynecological OncologyPractitioner - Obstetrics/Gynecology 4385711175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gynecological OncologyAlso: Obstetrics/Gynecology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Presbyterian HospitalGroup PAC ID 1153231907, 412 clinicians

Practice addresses (Care Compare)

125 Queens Rd
Charlotte, NC 28204-3215

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-9073

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39349KYMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Presbyterian Hospital Current Accepting new patients
The Presbyterian Hospital CurrentSince Oct 1, 2019 Accepting new patients
The Presbyterian Hospital CurrentSince Oct 1, 2019 Accepting new patients
Novant Health Medical Group Coastal Region, LLC Gynecologic Oncology Past Accepting new patients
Novant Medical Group, Inc. Past Accepting new patients

Locations

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

125 Queens Rd
Charlotte, NC 28204
Phone (980) 302-6380

125 Queens Rd
Ste 540
Charlotte, NC 28204
Phone (980) 302-6560

10905 Providence Rd W
Ste 150
Charlotte, NC 28277
Phone (980) 302-7120

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

10030 Gilead Rd
Ste 350
Huntersville, NC 28078
Phone (704) 799-3946

1700 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 841-8151

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.

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1467496869",
    "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": "125 QUEENS RD STE 540",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043215",
            "telephone_number": "980-302-6560",
            "fax_number": "980-302-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "JOHN",
        "middle_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "KY",
            "license": "39349",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "NC",
            "license": "9801384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64102924",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5909347",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmcdonald15714@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "125 Queens Rd Ste 540",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.