NPIMap

Individual provider Active NPI

Nathan Paul Doane, PA

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1720670870
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-11099 Issued in NC
Practice address
4741 Randolph Rd Ste 100
Charlotte, NC 28211-2919
Phone
(704) 365-6730
NPI assigned
Feb 10, 2021
Last updated
Mar 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9113991 FL
Physician Assistant 363A00000X 0010-11099 NC Primary

Addresses

Primary practice location

4741 Randolph Rd Ste 100
Charlotte, NC 28211-2919

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

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
I20230314001402 NC Practitioner - Physician Assistant 3072920214 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians

Practice addresses (Care Compare)

1901 Randolph Rd
Charlotte, NC 28207-1101
Phone (704) 316-2000

19485 Old Jetton Rd
Cornelius, NC 28031-6592

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

4741 Randolph Rd
Charlotte, NC 28211-2919
Phone (704) 365-6730

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9113991FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Medicorp Enterprises, LLC CurrentSince Feb 27, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 27, 2023 Accepting new patients
Carolina Medicorp Enterprises, LLC CurrentSince Feb 27, 2023 Accepting new patients
Novant Health Medical Group LLC CurrentSince Feb 27, 2023 Accepting new patients
Novant Medical Group, Inc. CurrentSince Feb 27, 2023 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

4741 Randolph Rd
#100
Charlotte, NC 28211
Phone (704) 365-6730

4741 Randolph Rd
Ste 100200
Charlotte, NC 28211
Phone (704) 365-6730

9550 Rocky River Rd
Ste 150
Charlotte, NC 28215
Phone (704) 457-1510

16525 Holly Crest Ln
Ste 150
Huntersville, NC 28078
Phone (704) 384-1725

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: ndoane1107471@direct.novanthealth.org

Organizations & group practices 9

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.

Hospital & facility affiliations 4

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": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1720670870",
    "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": "4741 RANDOLPH RD STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112919",
            "telephone_number": "704-365-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOANE",
        "first_name": "NATHAN",
        "middle_name": "PAUL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-10",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9113991",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.