Individual provider Active NPI

Tracela Vaden, MD

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1588698229
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
200300207 Issued in NC
Practice address
200 S College St
Ste 500
Charlotte, NC 28202-2012
Phone
(704) 302-8800
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 22945 SC
Internal Medicine Physician 207R00000X 200300207 NC Primary

Addresses

Primary practice location

200 S College St
Ste 500
Charlotte, NC 28202-2012

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

705 Griffith St
Ste 100
Davidson, NC 28036-9304
Phone (704) 801-7900

Other practice location 2

10650 Park Rd
Ste 420
Charlotte, NC 28210-8538
Phone (704) 302-8700

Other practice location 3

332 N Trade St
Ste 2000
Matthews, NC 28105-1728
Phone (704) 302-8500

Other practice location 4

15110 John J Delaney Dr
Ste 200
Charlotte, NC 28277-3544
Phone (704) 302-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20051205000622 NC Practitioner - Internal Medicine 3173543188 Reassigns benefits to 2 organizations
I20150910001813 SC Practitioner - Internal Medicine 3173543188

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200300207NCMDInternal Medicine Physician
22945SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Internal Medicine CurrentSince Sep 1, 2003 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Piedmont Physician Network LLC Internal Medicine Past Accepting new patients
Union Urgent Care LLC Past Accepting new patients
Union Urgent Care LLC Past Accepting new patients
American Family Care, LLC Past Accepting new patients
Carolinas Physicians Network Inc Internal Medicine Past Accepting new patients
Piedmont East Urgent Care Center LLC PastSince Sep 3, 2013 Accepting new patients
Piedmont Urgent Care Center at Baxter Village LLC Past Accepting new patients

Locations

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

9332 S Tryon St
Charlotte, NC 28273
Phone (704) 587-6700

10650 Park Rd
Ste 420
Charlotte, NC 28210
Phone (704) 302-8700

6030 W Highway 74
Indian Trail, NC 28079
Phone (704) 246-2777

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14929/brand/3/csg/1/fhir/r4

Organizations & group practices 10

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1588698229",
    "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": "200 S COLLEGE ST",
            "address_2": "STE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022012",
            "telephone_number": "704-302-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 Griffith St",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Davidson",
            "state": "NC",
            "postal_code": "280369304",
            "country_code": "US",
            "telephone_number": "704-801-7900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10650 Park Rd",
            "address_2": "Ste 420",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108538",
            "country_code": "US",
            "telephone_number": "704-302-8700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "332 N Trade St",
            "address_2": "Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281051728",
            "country_code": "US",
            "telephone_number": "704-302-8500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15110 John J Delaney Dr",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773544",
            "country_code": "US",
            "telephone_number": "704-302-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VADEN",
        "first_name": "TRACELA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "22945",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200300207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.