NPIMap

Individual provider Active NPI

Shantala Gopalakrishnan, MD

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1700891421
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
200400940 Issued in NC
Practice address
10628 Park Rd
Charlotte, NC 28210-8407
Phone
(704) 667-7070
NPI assigned
Jul 30, 2006
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 200400940 NC Primary
Hospitalist Physician 208M00000X 200400940 NC

Addresses

Primary practice location

10628 Park Rd
Charlotte, NC 28210-8407

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

2001 Vail Ave
Charlotte, NC 28207-1248
Phone (704) 304-6070

Other practice location 2

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-0720

Other practice location 3

920 Church St N
Suite 255
Concord, NC 28025-2927
Phone (704) 403-1331

Other practice location 4

8800 N Tryon St
Charlotte, NC 28262-3300
Phone (704) 863-6241

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sgopalakrishnan163064@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041019000881 NC Practitioner - HospitalistPractitioner - Internal Medicine 6204897747 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians
Scotland Regional Health NetworkGroup PAC ID 2365573185, 67 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000

1000 Healing Way
Matthews, NC 28104-4969
Phone (704) 371-2436

1020 Tree of Life LN
Cornelius, NC 28031-9454
Phone (704) 801-8210

10628 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-1000

10648 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-7070

1100 Blythe Blvd
Charlotte, NC 28203-5814
Phone (704) 355-4475

1130 Tree of Life LN
Cornelius, NC 28031-9454
Phone (980) 310-6160

2001 Vail Ave
Charlotte, NC 28207-1248
Phone (704) 304-5000

201 E Grover St
Shelby, NC 28150-3917
Phone (980) 487-3000

2301 US Hwy 74 W
Wadesboro, NC 28170-7554
Phone (704) 993-2240

329 Hwy 801 N
Bermuda Run, NC 27006
Phone (336) 716-2255

433 McAlister Rd
Lincolnton, NC 28092-4147
Phone (980) 212-2000

500 Lauchwood Dr
Laurinburg, NC 28352-5501
Phone (910) 277-9164

600 Hospital Dr
Monroe, NC 28112-6000
Phone (704) 283-3100

706 W King St
Kings Mountain, NC 28086-2708
Phone (704) 730-5470

8800 N Tryon St
Charlotte, NC 28262-3300
Phone (704) 863-6000

920 Church St N
Concord, NC 28025-2927
Phone (704) 403-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200400940NCMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jan 6, 2026 Accepting new patients
Carolinas Medical Center Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine CurrentSince Aug 22, 2016 Accepting new patients
Carolinas Medical Center CurrentSince Jan 28, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 1, 2007 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine Current Accepting new patients
Carolinas Physicians Network Inc Internal Medicine CurrentSince Jan 1, 2007 Accepting new patients
Scotland Regional Health Network CurrentSince Dec 15, 2020 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Aug 22, 2016 Accepting new patients
Scotland Regional Health Network Internal Medicine CurrentSince Dec 15, 2020 Accepting new patients
Carolinas Medical Center CurrentSince Jan 28, 2024 Accepting new patients
Internal Medicine Specialist, PA Internal Medicine Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

329 NC Highway 801 N
Bermuda Run, NC 27006
Phone (336) 716-8200

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

10628 Park Rd
Charlotte, NC 28210
Phone (704) 543-2000

2001 Vail Ave
Charlotte, NC 28207
Phone (704) 304-5000

501 Billingsley Rd
#B
Charlotte, NC 28211
Phone (704) 444-2400

920 Church St N
Ste 255
Concord, NC 28025
Phone (704) 403-1331

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: sgopalakrishnan163064@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1700891421",
    "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": "10628 PARK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108407",
            "telephone_number": "704-667-7070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 Vail Ave",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282071248",
            "country_code": "US",
            "telephone_number": "704-304-6070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Blythe Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035812",
            "country_code": "US",
            "telephone_number": "704-355-0720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "920 Church St N",
            "address_2": "Suite 255",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252927",
            "country_code": "US",
            "telephone_number": "704-403-1331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8800 N Tryon St",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623300",
            "country_code": "US",
            "telephone_number": "704-863-6241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOPALAKRISHNAN",
        "first_name": "SHANTALA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200400940",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "200400940",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgopalakrishnan163064@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "10628 Park Rd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282108407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.