NPIMap

Individual provider Active NPI

Michelle G Festa, MD

  • Family Medicine Physician
  • Concord, NC
National Provider Identifier
1679662712
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2022-00748 Issued in NC
Practice address
9955 Poplar Tent Rd
Concord, NC 28027-9314
Phone
(704) 316-1161
Fax
(704) 316-1162
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD047711L PA
Family Medicine Physician 207Q00000X MA60114 NJ
Family Medicine Physician 207Q00000X 2022-00748 NC Primary

Addresses

Primary practice location

9955 Poplar Tent Rd
Concord, NC 28027-9314

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

103 Old Marlton Pike
Suite 103
Medford, NJ 08055-8772
Phone (609) 953-7105

Other identifiers 4

IdentifierTypeStateIssuer
6672396OtherCIGNA
0713315000OtherAMERIHEALTH HMO, KESYSTONE, IBC
010002623OtherAMERICHOICE
6462804MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mfesta14175@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100420000909 NJ Practitioner - Family Practice 0143357376 Reassigns benefits to 1 organization
I20220413002045 NC Practitioner - Family Practice 0143357376 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians

Practice addresses (Care Compare)

10810 Mallard Creek Rd
Charlotte, NC 28262-9786
Phone (704) 510-8000

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

9955 Poplar Tent Rd
Charlotte, NC 28207-6304
Phone (704) 316-1161

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022-00748NCMDFamily Medicine Physician
MA60114NJMDFamily Medicine Physician
MD047711LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Medical Group, Inc. Current Accepting new patients
Virtua Medical Group, PA CurrentSince Jul 1, 2010 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 1, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 1, 2022 Accepting new patients
Novant Health Medical Group, LLC Family Medicine CurrentSince Apr 1, 2022 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

9955 Poplar Tent Rd
Concord, NC 28027
Phone (704) 316-1161

5325 Vinning St NW
Ste 101
Concord, NC 28027
Phone (704) 316-1040

7752 Gateway Ln NW
Ste 100
Concord, NC 28027
Phone (704) 316-4950

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

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

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

103 Old Marlton Pike
Ste 103
Medford, NJ 08055
Phone (609) 444-5715

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

Interoperability endpoints

  • Direct secure messaging: mfesta1037883@direct.novanthealth.org

Organizations & group practices 9

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 9

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1679662712",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9955 POPLAR TENT RD",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280279314",
            "telephone_number": "704-316-1161",
            "fax_number": "704-316-1162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Old Marlton Pike",
            "address_2": "Suite 103",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "NJ",
            "postal_code": "080558772",
            "country_code": "US",
            "telephone_number": "609-953-7105",
            "fax_number": "609-953-0042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FESTA",
        "first_name": "MICHELLE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD047711L",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA60114",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2022-00748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6672396",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH HMO, KESYSTONE, IBC",
            "identifier": "0713315000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "010002623",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6462804",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfesta14175@directvirtua.org",
            "affiliation": "N",
            "address_1": "103 Old Marlton Pike",
            "address_2": "Suite 103",
            "city": "Medford",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080558772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.