Individual provider Active NPI

Maya Dagher Fetter, MD

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1588955439
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2014-00704 Issued in NC
Practice address
16817 Marvin Rd
Charlotte, NC 28277-2196
Phone
(704) 495-6334
NPI assigned
Apr 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2014-00704 NC Primary
Internal Medicine Physician 207R00000X 38029 SC
Internal Medicine Physician 207R00000X 173258 NC

Addresses

Primary practice location

16817 Marvin Rd
Charlotte, NC 28277-2196

Mailing address

5960 Fairview Rd Ste 500
Charlotte, NC 28210-3113
Phone (704) 495-6334

Other practice location 1

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

Other identifiers 2

IdentifierTypeStateIssuer
1588955439MedicaidNC
NC2194MedicaidSC

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
I20141007002141 NC Practitioner - Internal Medicine 6901026301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Virginia Commonwealth University, School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tryon Medical Partners, PLLCGroup PAC ID 7113277971, 139 clinicians
The Weston Group IncGroup PAC ID 8123936796, shared by 8 NPIs, 215 clinicians

Practice addresses (Care Compare)

16817 Marvin Rd
Charlotte, NC 28277-2196
Phone (704) 495-6334

7745 Little Ave
Charlotte, NC 28226-8168
Phone (704) 541-9333

Hospital & facility affiliations

  • Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Novant Health Ballantyne Medical Center Hospital, Charlotte, NC, CCN 340195

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
173258NCMDInternal Medicine Physician
2014-00704NCMDInternal Medicine Physician
38029SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tryon Medical Partners, PLLC Internal Medicine CurrentSince Sep 4, 2018 Accepting new patients

Locations

5950 Fairview Rd
Ste 330
Charlotte, NC 28210

5960 Fairview Rd
Ste 500
Charlotte, NC 28210

16817 Marvin Rd
Charlotte, NC 28277
Phone (704) 275-3256

Interoperability endpoints

  • Direct secure messaging: maya.fetter.1@17847.direct.athenahealth.com

Organizations & group practices 1

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 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": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1588955439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5960 FAIRVIEW RD STE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103113",
            "telephone_number": "704-495-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16817 MARVIN RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282772196",
            "telephone_number": "704-495-6334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15110 John J Delaney Dr",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773544",
            "country_code": "US",
            "telephone_number": "704-302-8100",
            "fax_number": "704-302-8101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FETTER",
        "first_name": "MAYA",
        "middle_name": "DAGHER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-27",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2014-00704",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "38029",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "173258",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588955439",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2194",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.