Individual provider Active NPI

Maureen Anne O'Dell Choi

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1790280527
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2021-02469 Issued in NC
Practice address
8820 Rachel Freeman Way
Charlotte, NC 28278-9510
Phone
(704) 316-7227
Fax
(704) 316-7228
NPI assigned
Mar 25, 2018
Last updated
Aug 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X 2021-02469 NC Primary

Addresses

Primary practice location

8820 Rachel Freeman Way
Charlotte, NC 28278-9510

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

1000 Blythe Blvd Fl 4
Charlotte, NC 28203-5812
Phone (704) 381-6800

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
I20210831001813 NC Practitioner - Pediatric Medicine 8123375185 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021-02469NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatrics Pediatrics CurrentSince Aug 7, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 1, 2025 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
University Pediatrics Pediatrics CurrentSince Aug 7, 2023 Accepting new patients
Carolinas Physician Network Inc Pediatrics CurrentSince Jan 1, 2025 Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients

Locations

1000 Blythe Blvd
Fl 4
Charlotte, NC 28203
Phone (704) 355-8188

101 E Wt Harris Blvd
Charlotte, NC 28262
Phone (704) 863-0640

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

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

Interoperability endpoints

  • Direct secure messaging: mchoi902474@direct.novanthealth.org

Organizations & group practices 6

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": "1521936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1790280527",
    "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": "8820 RACHEL FREEMAN WAY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282789510",
            "telephone_number": "704-316-7227",
            "fax_number": "704-316-7228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Blythe Blvd Fl 4",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035812",
            "country_code": "US",
            "telephone_number": "704-381-6800",
            "fax_number": "704-381-6841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHOI",
        "first_name": "MAUREEN",
        "middle_name": "ANNE O'DELL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-25",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2021-02469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.