Individual provider Active NPI

Jeffrey Charles Cleary, MD

  • Pediatric Pulmonology Physician
  • Charlotte, NC
National Provider Identifier
1558437996
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
2018-02690 Issued in NC
Practice address
1001 Blythe Blvd
Medical Center Plaza Suite 200
Charlotte, NC 28203-5866
Phone
(704) 381-8840
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2018-02690 NC
Pediatric Pulmonology Physician 2080P0214X MD224100 OR
Pediatric Pulmonology Physician 2080P0214X 2018-02690 NC Primary

Addresses

Primary practice location

1001 Blythe Blvd
Medical Center Plaza Suite 200
Charlotte, NC 28203-5866

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1781 Tate Blvd SE
Hickory, NC 28602-4251
Phone (704) 381-8840

Other practice location 2

2550 Court Dr
Gastonia, NC 28054-2152
Phone (704) 381-8840

Other practice location 3

100 Medical Park Dr
Ste 310
Concord, NC 28025-2948
Phone (704) 403-2660

Other practice location 4

1001 Blythe Blvd
Ste 500
Charlotte, NC 28203-5866
Phone (704) 373-1813

Other practice location 5

501 N Graham St Ste 330A
Portland, OR 97227-2001
Phone (503) 413-2050

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address jcleary301577@CarolinasHealthcareSystem.direct-ci.com Atrium Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, OR, NY3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20190110001544 NC Practitioner - Pediatric MedicinePractitioner - Pulmonary Disease 4183921679 Reassigns benefits to 2 organizations
I20250403001504 OR Practitioner - Pediatric Medicine 4183921679 Reassigns benefits to 1 organization
I20250605002228 NY Practitioner - Pediatric Medicine 4183921679 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD224100ORMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center Pediatrics CurrentSince Nov 19, 2018 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Mar 25, 2025 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Medical Center CurrentSince Nov 19, 2018 Accepting new patients
Carolinas Physicians Network Inc CurrentSince May 30, 2021 Accepting new patients
Pediatric Allergy of Pulmonary Pediatric Pulmonology CurrentSince Jun 1, 2025 Accepting new patients
Legacy Emanuel Hospital & Health Center Pediatrics CurrentSince Mar 25, 2025 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Carolinas Medical Center Pediatrics Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince May 30, 2021 Accepting new patients
Pediatric Pulmonology Pediatric Pulmonology Past Accepting new patients

Locations

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

1001 Blythe Blvd
Ste 200
Charlotte, NC 28203
Phone (704) 373-0544

1001 Blythe Blvd
Ste 500
Charlotte, NC 28203
Phone (704) 355-5100

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

100 Medical Park Dr
Ste 310
Concord, NC 28025
Phone (704) 403-2860

2550 Court Dr
Gastonia, NC 28054
Phone (252) 773-0195

1781 Tate Blvd SE
Hickory, NC 28602
Phone (704) 446-1900

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

601 Elmwood Ave
#635
Rochester, NY 14642
Phone (585) 275-2821

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

501 N Graham St
Ste 330A
Portland, OR 97227
Phone (503) 413-2050

Interoperability endpoints

  • Direct secure messaging: jcleary301577@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 11

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1558437996",
    "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": "1001 BLYTHE BLVD",
            "address_2": "MEDICAL CENTER PLAZA SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035866",
            "telephone_number": "704-381-8840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1781 Tate Blvd SE",
            "address_purpose": "LOCATION",
            "city": "Hickory",
            "state": "NC",
            "postal_code": "286024251",
            "country_code": "US",
            "telephone_number": "704-381-8840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2550 Court Dr",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280542152",
            "country_code": "US",
            "telephone_number": "704-381-8840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Medical Park Dr",
            "address_2": "Ste 310",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252948",
            "country_code": "US",
            "telephone_number": "704-403-2660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 Blythe Blvd",
            "address_2": "Ste 500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035866",
            "country_code": "US",
            "telephone_number": "704-373-1813",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 N Graham St Ste 330A",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972272001",
            "country_code": "US",
            "telephone_number": "503-413-2050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEARY",
        "first_name": "JEFFREY",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2018-02690",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "OR",
            "license": "MD224100",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NC",
            "license": "2018-02690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "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"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcleary301577@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1001 Blythe Blvd",
            "address_2": "Medical Center Plaza, Suite 200",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282035866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.