Individual provider Active NPI

James Dierkes

  • Anesthesiology Physician
  • Charlotte, NC
National Provider Identifier
1497287262
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2022-01468 Issued in NC
Practice address
200 Hawthorne LN
Charlotte, NC 28204-2515
Phone
(704) 749-5800
Fax
(704) 626-3237
NPI assigned
Mar 31, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2022-01468 NC Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

200 Hawthorne LN
Charlotte, NC 28204-2515

Mailing address

3735 Glenlake Dr Ste 250
Charlotte, NC 28208-6866
Phone (704) 749-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221013000126 NC Practitioner - Anesthesiology 3577939784 Reassigns benefits to 2 organizations
I20250425000847 SC Practitioner - Anesthesiology 3577939784 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Temple University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Anesthesiology Associates PAGroup PAC ID 3971566761, 218 clinicians

Practice addresses (Care Compare)

10030 Gilead Rd
Huntersville, NC 28078-7545
Phone (704) 316-4000

1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone (704) 384-6500

1800 E 4TH St
Charlotte, NC 28204-3210
Phone (704) 384-1300

1901 Randolph Rd
Charlotte, NC 28207-1101
Phone (704) 316-2000

1918 Randolph Rd
Suite 740
Charlotte, NC 28207-1167
Phone (704) 316-0810

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-4000

240 Hospital Dr NE
Bolivia, NC 28422-8346
Phone (910) 721-1000

Hospital & facility affiliations

  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
  • Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183
  • Novant Health Brunswick Medical Center Hospital, Supply, NC, CCN 340158
  • Novant Health Ballantyne Medical Center Hospital, Charlotte, NC, CCN 340195

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022-01468NCMDAnesthesiology Physician
91374SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Anesthesiology Associates, P.a. Anesthesiology CurrentSince Jul 1, 2022 Accepting new patients

Locations

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

3735 Glenlake Dr
Ste 250
Charlotte, NC 28208
Phone (704) 749-5801

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

131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101

2536 Lengers Way
Indian Land, SC 29707
Phone (803) 313-3294

Interoperability endpoints

  • Direct secure messaging: jdierkes1051014@direct.novanthealth.org

Organizations & group practices 3

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 7

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": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1497287262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3735 GLENLAKE DR STE 250",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282086866",
            "telephone_number": "704-749-5800",
            "fax_number": "704-626-3237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWTHORNE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042515",
            "telephone_number": "704-749-5800",
            "fax_number": "704-626-3237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIERKES",
        "first_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-31",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2022-01468",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.