Jeffrey G Cardwell, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

39769 Issued in NC

Practice address

10816 Black Dog LN
Suite 160
Charlotte, NC 28214-1478

Phone

(704) 316-3970

Fax

(704) 316-3971

NPI assigned

Apr 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2018 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1700848710",
    "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": "704-510-8000",
            "fax_number": "704-510-8006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10816 BLACK DOG LN",
            "address_2": "SUITE 160",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282141478",
            "telephone_number": "704-316-3970",
            "fax_number": "704-316-3971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDWELL",
        "first_name": "JEFFREY",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "39769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8920658",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cardiosom, LLC
• Claudia Daniela Cardona, LCSWA
• Jennifer Cardona, LCSWA
• Josue Cardona, LPCA, NCC
• Brandy Cardwell, LAT, ATC
• Khamik Cardwell
• Care and Carry LLC
• Care Assistant LLC
• Care Club LLC
• Care Connection Help,LLC

• Family Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.