Individual provider Active NPI

Robert Ernest Gunnar Moulton, MD

  • Family Medicine Physician
  • Salisbury, NC
National Provider Identifier
1720642929
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2022-01018 Issued in NC
Practice address
530 Corporate Cir Ste 200
Salisbury, NC 28147-8074
Phone
(704) 637-7590
Fax
(704) 316-1880
NPI assigned
Apr 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 250076 NC
Family Medicine Physician 207Q00000X 2022-01018 NC Primary

Addresses

Primary practice location

530 Corporate Cir Ste 200
Salisbury, NC 28147-8074

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

4315 Physicians Blvd Ste 101
Harrisburg, NC 28075-7431
Phone (704) 455-6521

Other practice location 2

860 Jake Alexander Blvd W
Salisbury, NC 28147-1220
Phone (704) 637-7590

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rmoulton1068257@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220713001172 NC Practitioner - Family Practice 6901131143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

10810 Mallard Creek Rd
Charlotte, NC 28262-9786
Phone (704) 510-8000

548 White Oaks Dr
Salisbury, NC 28147-8183
Phone (704) 636-0271

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022-01018NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Family Medicine CurrentSince Feb 1, 2023 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 1, 2023 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

1035 Dale Earnhardt Blvd
Kannapolis, NC 28083
Phone (704) 316-1886

530 Corporate Cir
#200
Salisbury, NC 28147
Phone (704) 637-7590

860 Jake Alexander Blvd W
Salisbury, NC 28147
Phone (704) 637-1123

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

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

Interoperability endpoints

  • Direct secure messaging: rmoulton1068257@direct.novanthealth.org

Organizations & group practices 4

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 3

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": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1720642929",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 CORPORATE CIR STE 200",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281478074",
            "telephone_number": "704-637-7590",
            "fax_number": "704-316-1880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4315 Physicians Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "NC",
            "postal_code": "280757431",
            "country_code": "US",
            "telephone_number": "704-455-6521",
            "fax_number": "704-455-3078",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "860 Jake Alexander Blvd W",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281471220",
            "country_code": "US",
            "telephone_number": "704-637-7590",
            "fax_number": "704-316-1880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOULTON",
        "first_name": "ROBERT",
        "middle_name": "ERNEST GUNNAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-24",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "250076",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2022-01018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmoulton1068257@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "860 Jake Alexander Blvd W",
            "city": "Salisbury",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281471220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

Verify at the official NPI Registry.