Individual provider Active NPI

Oliver Wheeler Jervis Jr., M.D.

  • Pulmonary Disease Physician
  • Charlotte, NC
National Provider Identifier
1770542193
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
9900073 Issued in NC
Practice address
1918 Randolph Rd Ste 580
Charlotte, NC 28207-1116
Phone
(704) 384-9900
Fax
(704) 384-9919
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9900073 NC
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 9900073 NC
Pulmonary Disease Physician 207RP1001X 9900073 NC Primary

Addresses

Primary practice location

1918 Randolph Rd Ste 580
Charlotte, NC 28207-1116

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-9900

Other practice location 1

2209 S Sterling St Ste 600
Morganton, NC 28655-4092
Phone (828) 580-4577

Other practice location 2

1900 Randolph Rd Ste 580
Charlotte, NC 28207-1122
Phone (704) 384-9900

Other identifiers 2

IdentifierTypeStateIssuer
N00073MedicaidSC
891197YMedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address OJERVIS15004@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
I20100329000674 NC Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 5698801744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 1990
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

Practice addresses (Care Compare)

10030 Gilead Rd
Huntersville, NC 28078-7545
Phone (704) 316-4000

Hospital & facility affiliations

  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
  • Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
  • Novant Health Mint Hill Medical Center Hospital, Charlotte, NC, CCN 340190
  • Novant Health Ballantyne Medical Center Hospital, Charlotte, NC, CCN 340195

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9900073NCMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jun 14, 1999 Accepting new patients
Novant Health Medical Group, LLC Pulmonary Disease CurrentSince Jun 14, 1999 Accepting new patients
Novant Health Medical Group, LLC Internal Medicine Past Accepting new patients

Locations

11840 Southmore Dr
Ste 201
Charlotte, NC 28277
Phone (704) 316-9001

1918 Randolph Rd
Ste 580
Charlotte, NC 28207
Phone (704) 333-9113

201 Queens Rd
Charlotte, NC 28204
Phone (704) 316-5285

10030 Gilead Rd
Ste 300
Huntersville, NC 28078
Phone (704) 384-7972

10030 Gilead Rd
Huntersville, NC 28078
Phone (704) 316-4000

1750 Kernersville Medical Pkwy
Kernersville, NC 27284
Phone (336) 564-4000

1450 Matthews Township Pkwy
Ste 380
Matthews, NC 28105
Phone (704) 264-3500

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

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

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

222 Herlong Ave S
Rock Hill, SC 29732
Phone (803) 324-1950

Interoperability endpoints

  • Direct secure messaging: ojervis15004@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 7

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1770542193",
    "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",
            "telephone_number": "704-384-9900",
            "fax_number": "704-384-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 RANDOLPH RD STE 580",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071116",
            "telephone_number": "704-384-9900",
            "fax_number": "704-384-9919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2209 S Sterling St Ste 600",
            "address_purpose": "LOCATION",
            "city": "Morganton",
            "state": "NC",
            "postal_code": "286554092",
            "country_code": "US",
            "telephone_number": "828-580-4577",
            "fax_number": "828-580-4599",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1900 Randolph Rd Ste 580",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282071122",
            "country_code": "US",
            "telephone_number": "704-384-9900",
            "fax_number": "704-384-9919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JERVIS",
        "first_name": "OLIVER",
        "middle_name": "WHEELER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9900073",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NC",
            "license": "9900073",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NC",
            "license": "9900073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N00073",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891197Y",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "OJERVIS15004@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "1918 Randolph Rd Ste 580",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282071116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.