Individual provider Active NPI

John Bulter Plonk Jr., MD

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1730102211
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
32208 Issued in NC
Practice address
14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277-3372
Phone
(704) 667-2600
NPI assigned
Jul 25, 2006
Sex
Male
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 32208 NC Primary

Addresses

Primary practice location

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277-3372

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-1422

Other practice location 2

4501 Cameron Valley Pkwy
Ste 100
Charlotte, NC 28211-4297
Phone (704) 367-7400

Other practice location 3

7800 Providence Rd
Ste 203
Charlotte, NC 28226-2952
Phone (704) 512-2610

Other practice location 4

2544 Court Dr
Ste C
Gastonia, NC 28054-3450
Phone (704) 867-5356

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jplonk128601@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
I20211117003332 NC Practitioner - Pediatric Medicine 2567851207 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Dec 24, 2022 Accepting new patients
University Pediatrics Pediatrics CurrentSince Dec 24, 2022 Accepting new patients
Carolinas Physician Network Inc Pediatrics CurrentSince Dec 24, 2022 Accepting new patients
Charlotte Pediatric Clinic Pediatrics Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Pediatrics CurrentSince Dec 24, 2022 Accepting new patients
Carolinas Medical Center Pediatrics CurrentSince Dec 24, 2022 Accepting new patients
Carolinas Medical Center CurrentSince Dec 24, 2022 Accepting new patients
University Pediatrics Pediatrics CurrentSince Dec 24, 2022 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Dec 24, 2022 Accepting new patients
Carolinas Medical Center Pediatrics Current Accepting new patients
Carolinas Physicians Network Inc PastSince Jan 24, 2022 Accepting new patients

Locations

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

105 Yadkin St
Ste 303
Albemarle, NC 28001
Phone (704) 982-2683

13640 Steelecroft Pkwy
Ste 210
Charlotte, NC 28278
Phone (704) 512-6100

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

3541 Randolph Rd
Ste 206
Charlotte, NC 28211
Phone (704) 381-8336

15110 John J Delaney Dr
Ste 200
Charlotte, NC 28277
Phone (704) 302-8100

7800 Providence Rd
Ste 203
Charlotte, NC 28226
Phone (704) 512-2610

101 E Wt Harris Blvd
Ste 1121
Charlotte, NC 28262
Phone (704) 717-2000

4501 Cameron Valley Pkwy
Ste 100
Charlotte, NC 28211
Phone (704) 367-7400

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

251 Eastway Dr
Charlotte, NC 28213
Phone (704) 446-9991

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

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

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

705 Griffith St
Ste 100
Davidson, NC 28036
Phone (704) 801-7900

2544 Court Dr
Ste C
Gastonia, NC 28054
Phone (704) 867-5356

1550 Faulk St
Ste 1500
Monroe, NC 28112
Phone (704) 302-9700

Interoperability endpoints

  • Direct secure messaging: jplonk128601@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 and National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1730102211",
    "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": "14214 BALLANTYNE LAKE RD",
            "address_2": "STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773372",
            "telephone_number": "704-667-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-1422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4501 Cameron Valley Pkwy",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282114297",
            "country_code": "US",
            "telephone_number": "704-367-7400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7800 Providence Rd",
            "address_2": "Ste 203",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282262952",
            "country_code": "US",
            "telephone_number": "704-512-2610",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2544 Court Dr",
            "address_2": "Ste C",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280543450",
            "country_code": "US",
            "telephone_number": "704-867-5356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLONK",
        "first_name": "JOHN",
        "middle_name": "BULTER",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "32208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jplonk128601@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "14214 Ballantyne Lake Rd",
            "address_2": "Ste 300",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282773372",
            "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.