Individual provider Active NPI

Taylor White Sandberg, MD

  • Family Medicine Physician
  • Mooresville, NC
National Provider Identifier
1467957589
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2021-01569 Issued in NC
Practice address
150 Professional Park Dr
Ste 400
Mooresville, NC 28117-5603
Phone
(704) 801-7360
NPI assigned
Mar 29, 2018
Sex
Female
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
Family Medicine Physician 207Q00000X 2021-01569 NC Primary

Addresses

Primary practice location

150 Professional Park Dr
Ste 400
Mooresville, NC 28117-5603

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1900 Scott Ave
Ste 200
Charlotte, NC 28203-6046
Phone (704) 381-0260

Other practice location 2

13620 Reese Blvd E
Huntersville, NC 28078-6417
Phone (704) 801-7340

Other practice location 3

10226 Couloak Dr
Ste 100
Charlotte, NC 28216-7675
Phone (704) 801-7380

Other practice location 4

9611 Sherrill Estates Rd
Ste B
Huntersville, NC 28078-6485
Phone (704) 801-1150

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
I20210816003294 NC Practitioner - Family Practice 2668720640 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Brody School of Medicine at East Carolina University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrium Health North Market Network LLCGroup PAC ID 1557743440, 158 clinicians

Practice addresses (Care Compare)

16645 Birkdale Commons Pkwy
Suite 100
Huntersville, NC 28078-5669
Phone (704) 801-7390

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021-01569NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atrium Health North Market Network LLC Family Medicine CurrentSince Jan 1, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Aug 16, 2021 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Family Medicine CurrentSince Aug 16, 2021 Accepting new patients

Locations

1900 Scott Ave
Ste 200
Charlotte, NC 28203
Phone (704) 381-0260

4525 Cameron Valley Pkwy
Ste 4100D
Charlotte, NC 28211
Phone (704) 801-7310

10226 Couloak Dr
Ste 100
Charlotte, NC 28216
Phone (704) 801-7380

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

9611 Sherrill Estates Rd
Ste B
Huntersville, NC 28078
Phone (704) 801-1150

13620 Reese Blvd E
Huntersville, NC 28078
Phone (704) 801-7330

16645 Birkdale Commons Pkwy
Ste 100
Huntersville, NC 28078
Phone (704) 801-7390

150 Professional Park Dr
Ste 400
Mooresville, NC 28117
Phone (704) 801-7350

Interoperability endpoints

  • Direct secure messaging: tsandberg414900@carolinashealthcaresystem.direct-ci.com

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 6

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": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1467957589",
    "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": "150 PROFESSIONAL PARK DR",
            "address_2": "STE 400",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175603",
            "telephone_number": "704-801-7360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Scott Ave",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282036046",
            "country_code": "US",
            "telephone_number": "704-381-0260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13620 Reese Blvd E",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280786417",
            "country_code": "US",
            "telephone_number": "704-801-7340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10226 Couloak Dr",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282167675",
            "country_code": "US",
            "telephone_number": "704-801-7380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9611 Sherrill Estates Rd",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280786485",
            "country_code": "US",
            "telephone_number": "704-801-1150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDBERG",
        "first_name": "TAYLOR",
        "middle_name": "WHITE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2021-01569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.