Individual provider Active NPI

Andrea Drysdale Johnson, MD

  • Medical Oncology Physician
  • Charlotte, NC
National Provider Identifier
1720007107
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
200101565 Issued in NC
Practice address
10660 Park Rd
Ste 2100
Charlotte, NC 28210-8413
Phone
(980) 442-0410
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 200101565 NC
Hematology & Oncology Physician 207RH0003X 200101565 NC
Medical Oncology Physician 207RX0202X 200101565 NC Primary

Addresses

Primary practice location

10660 Park Rd
Ste 2100
Charlotte, NC 28210-8413

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1021 Morehead Medical Dr
Ste A
Charlotte, NC 28204-2990
Phone (980) 442-2000

Other practice location 2

945 N 5th St
Albemarle, NC 28001-3417
Phone (980) 323-7790

Other practice location 3

100 Medical Park Dr
Ste 110
Concord, NC 28025-2948
Phone (704) 403-1370

Other practice location 4

4525 Cameron Valley Pkwy
Ste 3500
Charlotte, NC 28211-4369
Phone (704) 302-8300

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ajohnson55574@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: 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
I20101203000379 NC Practitioner - Medical OncologyPractitioner - Hematology/OncologyPractitioner - Internal Medicine 5597952556 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200101565NCMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine CurrentSince Feb 5, 2018 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine Current Accepting new patients

Locations

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

1021 Morehead Medical Dr
Ste A
Charlotte, NC 28204
Phone (704) 355-2884

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

10660 Park Rd
Ste 2100
Charlotte, NC 28210
Phone (980) 442-0410

10650 Park Rd
Ste 250
Charlotte, NC 28210
Phone (704) 667-3910

Interoperability endpoints

  • Direct secure messaging: ajohnson55574@carolinashealthcaresystem.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1720007107",
    "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": "10660 PARK RD",
            "address_2": "STE 2100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108413",
            "telephone_number": "980-442-0410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1021 Morehead Medical Dr",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042990",
            "country_code": "US",
            "telephone_number": "980-442-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "945 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Albemarle",
            "state": "NC",
            "postal_code": "280013417",
            "country_code": "US",
            "telephone_number": "980-323-7790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Medical Park Dr",
            "address_2": "Ste 110",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252948",
            "country_code": "US",
            "telephone_number": "704-403-1370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4525 Cameron Valley Pkwy",
            "address_2": "Ste 3500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282114369",
            "country_code": "US",
            "telephone_number": "704-302-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANDREA",
        "middle_name": "DRYSDALE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200101565",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "200101565",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NC",
            "license": "200101565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajohnson55574@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "10660 Park Rd",
            "address_2": "Ste 2100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282108413",
            "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.