Individual provider Active NPI

Carissa Leigh Heibel, P.A.

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1689836306
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-04977 Issued in NC
Practice address
125 Queens Rd Ste 250
Charlotte, NC 28204-3419
Phone
(704) 316-5100
NPI assigned
Jun 25, 2008
Last updated
May 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-04977 NC Primary
Surgical Physician Assistant 363AS0400X 2128 TN

Addresses

Primary practice location

125 Queens Rd Ste 250
Charlotte, NC 28204-3419

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-5100

Other practice location 1

2555 Court Dr
Suite 200
Gastonia, NC 28054-2134
Phone (704) 867-2141

Other practice location 2

2555 Court Dr
Suite 200
Gastonia, NC 28054-2134
Phone (704) 867-2141

Other practice location 3

301 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 316-5100

Other identifiers 5

IdentifierTypeStateIssuer
1529055MedicaidTN
1689836306MedicaidNC
P01120793OtherTNRR MEDICARE
187725OtherNCBCBS NC
P01423324OtherNCMDCR RR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cheibel741462@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140910001484 NC Practitioner - Physician Assistant 3779658919 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

125 Queens Rd
Charlotte, NC 28204-3215

134 Medical Park Rd
Suite 200
Mooresville, NC 28117-8527
Phone (704) 384-7972

1901 Randolph Rd
Charlotte, NC 28207-1101
Phone (704) 316-2000

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 343-9800

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1278SCMDRegistered Dietitian
2128TNMDSpeech-Language Pathologist
0010-04977NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Presbyterian Hospital CurrentSince Sep 1, 2019 Accepting new patients
Novant Medical Group, Inc. CurrentSince Sep 1, 2019 Accepting new patients
Caromont Medical Group Inc CurrentSince Aug 8, 2014 Accepting new patients
Novant Medical Group Inc CurrentSince Sep 1, 2019 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Sep 1, 2019 Accepting new patients
The Presbyterian Hospital CurrentSince Sep 1, 2019 Accepting new patients
Caromont Medical Group Inc CurrentSince Aug 8, 2014 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

125 Baldwin Ave
Ste 200
Charlotte, NC 28204
Phone (704) 384-5043

125 Queens Rd
Ste 250
Charlotte, NC 28204
Phone (704) 316-2340

301 Hawthorne Ln
Ste 200
Charlotte, NC 28204
Phone (704) 316-5100

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

2555 Court Dr
Ste 200
Gastonia, NC 28054
Phone (704) 671-7670

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

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

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

Organizations & group practices 12

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.

Hospital & facility affiliations 4

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": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1689836306",
    "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": "704-316-5100",
            "fax_number": "704-316-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD STE 250",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043419",
            "telephone_number": "704-316-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2555 Court Dr",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280542134",
            "country_code": "US",
            "telephone_number": "704-867-2141",
            "fax_number": "704-867-2308",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2555 Court Dr",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280542134",
            "country_code": "US",
            "telephone_number": "704-867-2141",
            "fax_number": "704-867-2308",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Hawthorne Ln",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28204",
            "country_code": "US",
            "telephone_number": "704-316-5100",
            "fax_number": "704-316-5101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEIBEL",
        "first_name": "CARISSA",
        "middle_name": "LEIGH",
        "name_prefix": "Miss",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-25",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04977",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "2128",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1529055",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689836306",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01120793",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "187725",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDCR RR",
            "identifier": "P01423324",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cheibel741462@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2555 Court Dr",
            "address_2": "Suite 200",
            "city": "Gastonia",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280542134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.