Glen Powell Jr., MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

2008-00406 Issued in NC

Practice address

101 E W T Harris Blvd
Ste 2320
Charlotte, NC 28262-3485

Phone

(704) 547-0858

NPI assigned

Nov 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Obstetrics/Gynecology

Education

University of Louisville School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: glen.powell.p1@direct.ncfmc.nextgenshare.com

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.

• Caromont Medical Group Inc

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1356314272

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Obhg North Carolina, P.C.

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
  • NPI 1124300876
  Medicare reassignment NPD
• Caromont Medical Group Inc

  • Maternal & Fetal Medicine Physician
  • Gastonia, NC
  • NPI 1811761349
  NPD
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Stanley, NC
  • NPI 1972301380
  NPD

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1578743159",
    "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": "101 E W T HARRIS BLVD",
            "address_2": "STE 2320",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623485",
            "telephone_number": "704-547-0858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16455 Statesville Rd",
            "address_2": "Ste 400",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787135",
            "country_code": "US",
            "telephone_number": "704-801-2130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWELL",
        "first_name": "GLEN",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-12",
        "last_updated": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2008-00406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Douglas Powell, MD
• Christina Tonae Powell, PA
• Courtney Helms Powell, NP-C
• Deedda Renae Powell, DNP-PMHNP
• Denise Griffin Powell, COTA/L
• Jacqueline Nicole Powell, MA CCC-SLP
• Joseph Finley Powell IV, CRNA
• Kaitlyn Powell
• Karen Roberta Joyce Powell, LCSW-A
• Kelly Jo Powell, COTA

• Obstetrics & Gynecology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Obstetrics & Gynecology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.