NPIMap

Individual provider Active NPI

Charles Albert Withers II, M.D.

  • Rheumatology Physician
  • Charlotte, NC
National Provider Identifier
1598928202
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
2013-01881 Issued in NC
Practice address
10826 Mallard Creek Rd Ste 100
Charlotte, NC 28262-7785
Phone
(704) 774-3044
Fax
(704) 774-3045
NPI assigned
Jul 3, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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 150029 NC
Rheumatology Physician 207RR0500X 2013-01881 NC Primary

Addresses

Primary practice location

10826 Mallard Creek Rd Ste 100
Charlotte, NC 28262-7785

Mailing address

10826 Mallard Creek Rd Ste 100
Charlotte, NC 28262-7785
Phone (704) 774-3044

Other practice location 1

3125 Springbank Lane
Suite E
Charlotte, NC 28226-3379
Phone (704) 774-3044

Other identifiers 1

IdentifierTypeStateIssuer
1598928202MedicaidNC

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
I20120203000775 NC Practitioner - RheumatologyPractitioner - Internal Medicine 0042477945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Duke University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrative Rheumatology PLLCGroup PAC ID 2365724127, 4 clinicians

Practice addresses (Care Compare)

10826 Mallard Creek Rd
Suite 100
Charlotte, NC 28262-7785
Phone (704) 774-3044

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
150029NCMDInternal Medicine Physician
2013-01881NCMDRheumatology Physician

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 6

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": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1598928202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10826 MALLARD CREEK RD STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282627785",
            "telephone_number": "704-774-3044",
            "fax_number": "704-774-3045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10826 MALLARD CREEK RD STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282627785",
            "telephone_number": "704-774-3044",
            "fax_number": "704-774-3045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3125 Springbank Lane",
            "address_2": "Suite E",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282263379",
            "country_code": "US",
            "telephone_number": "704-774-3044",
            "fax_number": "704-774-3045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITHERS",
        "first_name": "CHARLES",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-03",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "150029",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NC",
            "license": "2013-01881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598928202",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.