Individual provider Active NPI

Mary Ann Knovich, MD

  • Hematology (Internal Medicine) Physician
  • Charlotte, NC
National Provider Identifier
1750365128
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
9800299 Issued in NC
Practice address
1021 Morehead Medical Dr
Ste a
Charlotte, NC 28204-2990
Phone
(980) 442-2000
NPI assigned
Nov 30, 2005
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 9800299 NC
Hematology (Internal Medicine) Physician 207RH0000X 9800299 NC Primary

Addresses

Primary practice location

1021 Morehead Medical Dr
Ste a
Charlotte, NC 28204-2990

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

2610 Aberdeen Blvd
Gastonia, NC 28054-0637
Phone (980) 442-4500

Other practice location 2

10660 Park Rd
Ste 2100
Charlotte, NC 28210-8413
Phone (980) 442-0410

Other practice location 3

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

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mknovich137113@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
I20040825001308 NC Practitioner - Hematology/Oncology 2062486871 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Pennsylvania State University College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9800299NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jul 1, 2003 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine CurrentSince May 19, 2014 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince May 19, 2014 Accepting new patients
Carolinas Medical Center-Northeast Past 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

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

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

2610 Aberdeen Blvd
Gastonia, NC 28054
Phone (704) 865-5210

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

Interoperability endpoints

  • Direct secure messaging: mknovich137113@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

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 6

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": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1750365128",
    "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": "1021 MOREHEAD MEDICAL DR",
            "address_2": "STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042990",
            "telephone_number": "980-442-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2610 Aberdeen Blvd",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280540637",
            "country_code": "US",
            "telephone_number": "980-442-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10660 Park Rd",
            "address_2": "Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108413",
            "country_code": "US",
            "telephone_number": "980-442-0410",
            "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": "KNOVICH",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9800299",
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "NC",
            "license": "9800299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mknovich137113@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1021 Morehead Medical Dr",
            "address_2": "Ste A",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042990",
            "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.