Individual provider Active NPI

Jodia M. Slater, FNP

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1609905983
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5002900 Issued in NC
Practice address
9550 Rocky River Rd Ste 150
Charlotte, NC 28215-9592
Phone
(704) 457-1510
Fax
(704) 457-1506
NPI assigned
Mar 5, 2007
Last updated
Aug 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 214803 NC
Family Nurse Practitioner 363LF0000X 0050-02900 NC
Nurse Practitioner 363L00000X 5002900 NC Primary

Addresses

Primary practice location

9550 Rocky River Rd Ste 150
Charlotte, NC 28215-9592

Mailing address

PO Box 601843
Charlotte, NC 28260-1843

Other practice location 1

7810 Providence Road
Suite 102
Charlotte, NC 28226-2987
Phone (704) 631-0002

Other identifiers 2

IdentifierTypeStateIssuer
1609905983MedicaidNC
NP1101MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jslater748002@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3053SCMDRegistered Dietitian
0050-02900NCMDFamily Nurse Practitioner
214803NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Emergency Medical Associates, PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jslater748002@direct.novanthealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1609905983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601843",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550 ROCKY RIVER RD STE 150",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282159592",
            "telephone_number": "704-457-1510",
            "fax_number": "704-457-1506"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7810 Providence Road",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282262987",
            "country_code": "US",
            "telephone_number": "704-631-0002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLATER",
        "first_name": "JODIA",
        "middle_name": "M.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "214803",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "0050-02900",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5002900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609905983",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1101",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jslater748002@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "9550 Rocky River Rd Ste 150",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282159592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.