Individual provider Active NPI

Traci Aurelia Ladd, M.D.

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1659363489
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
9901431 Issued in NC
Practice address
14215 Ballantyne Corporate Park
Suite 130
Charlotte, NC 28277
Phone
(704) 384-1950
Fax
(704) 384-1955
NPI assigned
Aug 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 9901431 NC Primary

Addresses

Primary practice location

14215 Ballantyne Corporate Park
Suite 130
Charlotte, NC 28277

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-1950

Other identifiers 2

IdentifierTypeStateIssuer
N01437MedicaidSC
891288MMedicaidNC

Other names 1

  • Traci Ladd Lamothe Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tlamothe14599@direct.novanthealth.org

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
I20230712004497 NC Practitioner - Pediatric Medicine 4789936048 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group LLC Pediatrics CurrentSince May 29, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 29, 2023 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

517 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 384-1406

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 4

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1659363489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-1950",
            "fax_number": "704-384-1955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14215 BALLANTYNE CORPORATE PARK",
            "address_2": "SUITE 130",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28277",
            "telephone_number": "704-384-1950",
            "fax_number": "704-384-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADD",
        "first_name": "TRACI",
        "middle_name": "AURELIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2020-10-28",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9901431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N01437",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891288M",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tlamothe14599@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "14215 Ballantyne Corporate Park",
            "address_2": "Suite 130",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "LAMOTHE",
            "middle_name": "LADD",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.