Individual provider Active NPI

Nicholas Rapheal Punch, DO

  • Critical Care Medicine (Internal Medicine) Physician
  • Concord, NC
National Provider Identifier
1538508734
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
2024-00617 Issued in NC
Practice address
920 Church St N
Concord, NC 28025-2927
Phone
(704) 403-1311
NPI assigned
Jun 20, 2013
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Male
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2024-00617 NC
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 2024-00617 NC Primary

Addresses

Primary practice location

920 Church St N
Concord, NC 28025-2927

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-4490

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address npunch2880872@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC2 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
I20190913000060 FL Practitioner - Critical Care (Intensivists) 8123329018 Reassigns benefits to 3 organizations
I20240522003516 NC Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 8123329018 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians

Practice addresses (Care Compare)

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 355-7328

920 Church St N
Concord, NC 28025-2927
Phone (704) 403-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024-00617NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jan 18, 2026 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Critical Care Medicine CurrentSince May 13, 2024 Accepting new patients
Florida Hospital Medical Group Inc Internal Medicine CurrentSince Oct 11, 2021 Accepting new patients
Accountable Critical Care LLC Critical Care Medicine CurrentSince Sep 1, 2021 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Oct 11, 2021 Accepting new patients
Nuview Telehealth, LLC Internal Medicine CurrentSince Mar 5, 2022 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine Current Accepting new patients
Carolinas Medical Center Critical Care Medicine CurrentSince May 13, 2024 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince May 13, 2024 Accepting new patients
Carolinas Medical Center CurrentSince May 13, 2024 Accepting new patients
Carolinas Medical Center-Northeast Past Accepting new patients

Locations

206 2nd St E
Bradenton, FL 34208
Phone (941) 745-7202

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

2501 N Orange Ave
Ste 401
Orlando, FL 32804

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

10101 Forest Hill Blvd
West Palm Beach, FL 33414
Phone (561) 766-1301

1155 S Congress Ave
Ste C
West Palm Beach, FL 33406
Phone 5617661300501

1309 N Flagler Dr
West Palm Beach, FL 33401
Phone (561) 650-6309

3360 Burns Rd
West Palm Beach, FL 33410
Phone (561) 622-1411

100 N 6th St
Ste 900A
Minneapolis, MN 55403

329 NC Highway 801 N
Bermuda Run, NC 27006
Phone (336) 716-8200

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

1370 W D St
North Wilkesboro, NC 28659
Phone (336) 651-8100

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: npunch144597@adventhealth.direct-ci.com
  • Direct secure messaging: npunch2880872@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 12

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.

Hospital & facility affiliations 2

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": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1538508734",
    "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": "920 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252927",
            "telephone_number": "704-403-1311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-4490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUNCH",
        "first_name": "NICHOLAS",
        "middle_name": "RAPHEAL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-20",
        "last_updated": "2024-07-15",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2024-00617",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NC",
            "license": "2024-00617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "npunch2880872@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "920 Church St N",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252927",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.