Individual provider Active NPI

Hebah Sadek Pranckun, DO

  • Pediatrics Physician
  • Albemarle, NC
National Provider Identifier
1760937049
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2023-02683 Issued in NC
Practice address
105 Yadkin St
Ste 303
Albemarle, NC 28001-3449
Phone
(980) 323-5400
NPI assigned
Aug 17, 2016
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2023-02683 NC Primary

Addresses

Primary practice location

105 Yadkin St
Ste 303
Albemarle, NC 28001-3449

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address hpranckun2705522@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 GA, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200106003146 GA Practitioner - Pediatric Medicine 8022305218 Reassigns benefits to 1 organization
I20231112000088 NC Practitioner - Pediatric Medicine 8022305218 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Dec 1, 2019 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Dec 1, 2019 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 2, 2023 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Carolinas Physician Network Inc Pediatrics CurrentSince Oct 2, 2023 Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients

Locations

2450 Old Milton Pkwy
Ste 203
Alpharetta, GA 30009
Phone (470) 267-0380

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

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

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

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

Interoperability endpoints

  • Direct secure messaging: hpranckun2705522@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: hsadekpranckun351235@directwellstar.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1760937049",
    "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": "105 YADKIN ST",
            "address_2": "STE 303",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013449",
            "telephone_number": "980-323-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRANCKUN",
        "first_name": "HEBAH",
        "middle_name": "SADEK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-17",
        "last_updated": "2024-07-15",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2023-02683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hpranckun2705522@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "105 Yadkin St",
            "address_2": "Ste 303",
            "city": "Albemarle",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280013449",
            "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 Albemarle, NC

Sources for this page

Verify at the official NPI Registry.