Individual provider Active NPI

Charles Matthew Pesson, MD

  • Orthopaedic Surgery Physician
  • Morehead, KY
National Provider Identifier
1699778613
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
53502 Issued in KY
Practice address
245 Flemingsburg Rd
Morehead, KY 40351-1015
Phone
(606) 780-5500
Fax
(606) 783-7281
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 53502 KY
Orthopaedic Surgery Physician 207X00000X 53502 KY Primary

Addresses

Primary practice location

245 Flemingsburg Rd
Morehead, KY 40351-1015

Mailing address

245 Flemingsburg Rd
Morehead, KY 40351-1015
Phone (606) 780-5500

Other identifiers 2

IdentifierTypeStateIssuer
7100658660MedicaidKY
53502OtherKYKY MEDICAL LICENSE

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
I20241002000912 NC Practitioner - Orthopedic Surgery 1557258464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Louisiana State University School of Medicine in New Orleans, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

250 Smith Church Rd
Roanoke Rapids, NC 27870-4914
Phone (252) 535-8011

Hospital & facility affiliations

  • Ecu Health North Hospital Hospital, Roanoke Rapids, NC, CCN 340151
  • Vidant Roanoke Chowan Hospital Hospital, Ahoskie, NC, CCN 340099
  • Vidant Edgecombe Hospital Hospital, Tarboro, NC, CCN 340107
  • Ecu Health Medical Center Hospital, Greenville, NC, CCN 340040

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
73.64 of 100Reported as group
Quality
56.63
Improvement activities
40
Cost
74.98

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement12
Knee replacement15
Lower limb (leg) arthroscopy (minimally invasive joint repair)24
Upper limb (arm) arthroscopy (minimally invasive joint repair)18
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Jul 29, 2024 Accepting new patients
Harbin Clinic, LLC Current Accepting new patients

Locations

1825 Martha Berry Blvd NW
Rome, GA 30165
Phone (706) 238-8073

221 Technology Pkwy NW
Rome, GA 30165
Phone (762) 235-1000

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

250 Smith Church Rd
Roanoke Rapids, NC 27870
Phone (252) 308-9699

Organizations & group practices 2

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 5

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1699778613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 FLEMINGSBURG RD",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403511015",
            "telephone_number": "606-780-5500",
            "fax_number": "606-783-7281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 FLEMINGSBURG RD",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403511015",
            "telephone_number": "606-780-5500",
            "fax_number": "606-783-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESSON",
        "first_name": "CHARLES",
        "middle_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "KY",
            "license": "53502",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "KY",
            "license": "53502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100658660",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY MEDICAL LICENSE",
            "identifier": "53502",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead, KY

Sources for this page

Verify at the official NPI Registry.