Individual provider Active NPI

Michelle Brody, DO

  • Pediatrics Physician
  • Huntersville, NC
National Provider Identifier
1689698474
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
9801187 Issued in NC
Practice address
9625 Northcross Center CT
Suite 201
Huntersville, NC 28078-7348
Phone
(704) 801-3097
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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 9801187 NC Primary

Addresses

Primary practice location

9625 Northcross Center CT
Suite 201
Huntersville, NC 28078-7348

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

9908 Couloak Dr
Suite 103
Charlotte, NC 28216-8678
Phone (704) 801-2025

Other practice location 2

1585 Forney Creek Pkwy
Suite 2100
Denver, NC 28037-9514
Phone (704) 801-3097

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)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
9801187NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Pediatrics and Adolescent Medicine, PA Pediatrics Past Accepting new patients
South Lake Pediatrics Pediatrics PastSince Nov 24, 2019 Accepting new patients
Carolinas Physicians Network Inc Pediatrics Past Accepting new patients
Pediatric Housecall Services PLLC Pediatrics Past Accepting new patients

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1689698474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9625 NORTHCROSS CENTER CT",
            "address_2": "SUITE 201",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787348",
            "telephone_number": "704-801-3097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9908 Couloak Dr",
            "address_2": "Suite 103",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282168678",
            "country_code": "US",
            "telephone_number": "704-801-2025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1585 Forney Creek Pkwy",
            "address_2": "Suite 2100",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "NC",
            "postal_code": "280379514",
            "country_code": "US",
            "telephone_number": "704-801-3097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRODY",
        "first_name": "MICHELLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9801187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.