NPIMap

Individual provider Active NPI

Corey Scott Mottesheard, D.O.

  • Family Medicine Physician
  • Cornelius, NC
National Provider Identifier
1578098232
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2019-02398 Issued in NC
Practice address
19485 Old Jetton Rd Ste 100
Cornelius, NC 28031-6583
Phone
(704) 384-1775
Fax
(704) 384-1776
NPI assigned
May 1, 2017
Last updated
Oct 26, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 228372 NC
Family Medicine Physician 207Q00000X 2019-02398 NC Primary

Addresses

Primary practice location

19485 Old Jetton Rd Ste 100
Cornelius, NC 28031-6583

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

10030 Gilead Road
Novant Health Huntersville Medical Center
Huntersville, NC 28078
Phone (704) 316-4000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmottesheard445773@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200721000713 NC Practitioner - Family Practice 5092088377 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

10810 Mallard Creek Rd
Charlotte, NC 28262-9786
Phone (704) 510-8000

19485 Old Jetton Rd
Suite 100
Cornelius, NC 28031-6583
Phone (704) 384-1775

548 White Oaks Dr
Salisbury, NC 28147-8183
Phone (704) 636-0271

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019-02398NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Feb 1, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 2, 2020 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 2, 2020 Accepting new patients
Novant Medical Group, Inc. Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

19485 Old Jetton Rd
Ste 100
Cornelius, NC 28031
Phone (704) 316-5170

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

16525 Holly Crest Ln
Ste 150
Huntersville, NC 28078
Phone (704) 384-1725

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: cmottesheard445773@direct.novanthealth.org

Organizations & group practices 6

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 8

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": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1578098232",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19485 OLD JETTON RD STE 100",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280316583",
            "telephone_number": "704-384-1775",
            "fax_number": "704-384-1776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10030 Gilead Road",
            "address_2": "Novant Health Huntersville Medical Center",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "28078",
            "country_code": "US",
            "telephone_number": "704-316-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOTTESHEARD",
        "first_name": "COREY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-01",
        "last_updated": "2020-10-26",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "228372",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2019-02398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmottesheard445773@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "10030 Gilead Road",
            "address_2": "Novant Health Huntersville Medical Center",
            "city": "Huntersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

Verify at the official NPI Registry.