Individual provider Active NPI

Ismaeel Badr Hashemi, MD

  • Pediatric Gastroenterology Physician
  • Charlotte, NC
National Provider Identifier
1821288705
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
955858 Issued in NC
Practice address
1918 Randolph Rd Ste 210
Charlotte, NC 28207-1109
Phone
(704) 316-5060
Fax
(704) 316-5069
NPI assigned
Jul 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 4301095879 MI
Pediatric Gastroenterology Physician 2080P0206X 955858 NC Primary

Addresses

Primary practice location

1918 Randolph Rd Ste 210
Charlotte, NC 28207-1109

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-5060

Other practice location 1

2711 Randolph Rd Ste 301
Charlotte, NC 28207-2027
Phone (704) 316-5060

Other practice location 2

35 Michigan St NE
Suite 4150
Grand Rapids, MI 49503-2514
Phone (616) 267-2100

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
I20230509000631 NC Practitioner - Pediatric MedicinePractitioner - Gastroenterology 5092958108 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
955858NCMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Pediatric Gastroenterology CurrentSince May 1, 2023 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 1, 2023 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

2711 Randolph Rd
Ste 301
Charlotte, NC 28207
Phone (704) 330-1700

1918 Randolph Rd
Ste 210
Charlotte, NC 28207
Phone (704) 247-2209

6331 Carmel Rd
Ste 102
Charlotte, NC 28226
Phone (704) 316-2354

17810 Statesville Rd
Ste 311
Cornelius, NC 28031
Phone (704) 655-6300

1574 Union Rd
Ste A
Gastonia, NC 28054
Phone (704) 866-4607

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

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

Interoperability endpoints

  • Direct secure messaging: ihashemi1114147@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.

NPI Registry JSON

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1821288705",
    "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": "704-316-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 RANDOLPH RD STE 210",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071109",
            "telephone_number": "704-316-5060",
            "fax_number": "704-316-5069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2711 Randolph Rd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072027",
            "country_code": "US",
            "telephone_number": "704-316-5060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "35 Michigan St NE",
            "address_2": "Suite 4150",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495032514",
            "country_code": "US",
            "telephone_number": "616-267-2100",
            "fax_number": "616-267-2101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASHEMI",
        "first_name": "ISMAEEL",
        "middle_name": "BADR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-27",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MI",
            "license": "4301095879",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NC",
            "license": "955858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.