Individual provider Active NPI

Sam R Fulp, M.D.

  • Gastroenterology Physician
  • Charlotte, NC
National Provider Identifier
1548218118
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
32500 Issued in NC
Practice address
11430 Red Rust LN Ste 201
Charlotte, NC 28277-4948
Phone
(704) 377-4009
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 32500 NC Primary

Addresses

Primary practice location

11430 Red Rust LN Ste 201
Charlotte, NC 28277-4948

Mailing address

PO Box 497
Huntersville, NC 28070-0497
Phone (704) 377-4009

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
I20050502000828 NC Practitioner - Gastroenterology 2466491113 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Wake Forest University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charlotte Gastroenterology and Hepatology PLLCGroup PAC ID 3870489412, shared by 3 NPIs, 76 clinicians

Practice addresses (Care Compare)

2015 Randolph Rd
Charlotte, NC 28207-1200
Phone (704) 377-4009

Hospital & facility affiliations

  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
  • Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
  • Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183

Merit-based Incentive Payment System (MIPS)

Final score
95.22 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
84.08

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy25
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32500NCMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Gastroenterology & Hepatology, PLLC CurrentSince Apr 1, 2002 Accepting new patients
Charlotte Gastroenterology & Hepatology, PLLC Gastroenterology CurrentSince Apr 1, 2002 Accepting new patients
Mecklenburg Medical Group Gastroenterology Past Accepting new patients
Charlotte Gastroenterology & Hepatology, PLLC Past Accepting new patients

Locations

2015 Randolph Rd
Ste 208
Charlotte, NC 28207
Phone (704) 602-6544

15830 Ballantyne Medical Pl
Ste 175
Charlotte, NC 28277
Phone (704) 323-7633

15830 Ballantyne Medical Pl
Ste 150
Charlotte, NC 28277

11430 Red Rust Ln
Ste 201
Charlotte, NC 28277

4425 Randolph Rd
Ste 105
Charlotte, NC 28211

2015 Randolph Rd
Ste 101
Charlotte, NC 28207
Phone (704) 602-6544

16525 Holly Crest Ln
Ste 120
Huntersville, NC 28078
Phone (704) 316-5388

13808 Professional Center Dr
Huntersville, NC 28078
Phone (704) 717-5549

1340 Matthews Township Pkwy
Ste 301
Matthews, NC 28105
Phone (704) 384-8460

1450 Matthews Township Pkwy
Ste 400
Matthews, NC 28105
Phone (704) 316-5140

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1548218118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 497",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280700497",
            "telephone_number": "704-377-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11430 RED RUST LN STE 201",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774948",
            "telephone_number": "704-377-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULP",
        "first_name": "SAM",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "32500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.