Individual provider Active NPI

Edward Conrad Robles, MD

  • Neurology Physician
  • Huntersville, NC
National Provider Identifier
1548269962
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2015-00266 Issued in NC
Practice address
10305 Hamptons Park Dr Ste 101
Huntersville, NC 28078-7217
Phone
(704) 316-5388
Fax
(704) 316-1848
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4301066617 MI
Neurology Physician 2084N0400X 4301066617 MI
Neurology Physician 2084N0400X 2015-00266 NC Primary

Addresses

Primary practice location

10305 Hamptons Park Dr Ste 101
Huntersville, NC 28078-7217

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-5388

Other identifiers 2

IdentifierTypeStateIssuer
1548269962MedicaidNC
104127966MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address erobles240222@direct.novanthealth.org

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
I20150909000370 NC Practitioner - NeurologyPractitioner - Physical Medicine and Rehabilitation 6002878345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Physical Medicine and Rehabilitation
Education
New York Medical College, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians
Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 clinicians

Practice addresses (Care Compare)

10305 Hamptons Park Dr
Suite 101
Huntersville, NC 28078-7221
Phone (704) 384-5520

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3367 N NC 16 Business Hwy
Denver, NC 28037-8265
Phone (419) 221-6717

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

5145 Sellers Rd
Shallotte, NC 28470-3405
Phone (910) 754-4572

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301066617MIMDNeurology Physician
2015-00266NCMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Medical Group, Inc CurrentSince Jul 1, 2015 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 1, 2015 Accepting new patients
Wa Foote Memorial Hospital, Inc Past Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

10305 Hamptons Park Dr
Ste 101
Huntersville, NC 28078
Phone (704) 316-5388

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: erobles240222@direct.novanthealth.org

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 5

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1548269962",
    "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",
            "telephone_number": "704-316-5388",
            "fax_number": "704-316-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10305 HAMPTONS PARK DR STE 101",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787217",
            "telephone_number": "704-316-5388",
            "fax_number": "704-316-1848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBLES",
        "first_name": "EDWARD",
        "middle_name": "CONRAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301066617",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301066617",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2015-00266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548269962",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104127966",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "erobles240222@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "10305 Hamptons Park Dr Ste 101",
            "city": "Huntersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280787217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

Verify at the official NPI Registry.