Individual provider Active NPI

Eric Thomas Warren, MD

  • Sports Medicine (Family Medicine) Physician
  • Charlotte, NC
National Provider Identifier
1831220292
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
200500275 Issued in NC
Practice address
11530 Providence Rd
Ste 1300
Charlotte, NC 28277-2691
Phone
(704) 667-0780
NPI assigned
Mar 8, 2007
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Male
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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 200500275 NC
Sports Medicine (Family Medicine) Physician 207QS0010X 200500275 NC Primary
Sports Medicine (Internal Medicine) Physician 207RS0010X 200500275 NC
Orthopaedic Surgery Physician 207X00000X 200500275 NC
General Practice Physician 208D00000X 200500275 NC

Addresses

Primary practice location

11530 Providence Rd
Ste 1300
Charlotte, NC 28277-2691

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

5651 Poplar Tent Rd
Ste 102
Concord, NC 28027-7686
Phone (704) 863-4878

Other practice location 2

5735 Prosperity Crossing Dr
Ste 2100
Charlotte, NC 28269-1360
Phone (704) 863-4878

Other practice location 3

14214 Ballantyne Lake Rd
Ste 150
Charlotte, NC 28277-3372
Phone (704) 863-4878

Other practice location 4

9726 Sam Furr Rd
Huntersville, NC 28078-8218
Phone (704) 863-4878

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ewarren454175@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, SC2 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
I20070912000483 NC Practitioner - Family PracticePractitioner - Sports Medicine 2365535903 Reassigns benefits to 3 organizations
I20201211000842 SC Practitioner - Sports MedicinePractitioner - Family Practice 2365535903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
University of North Carolina at Chapel Hill School of Medicine, 2003
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, shared by 56 NPIs, 2,324 clinicians
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians

Practice addresses (Care Compare)

1690 Hwy 160 W
Fort Mill, SC 29708-8024
Phone (803) 548-2424

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

5651 Poplar Tent Rd
Suite 102
Concord, NC 28027-7686
Phone (704) 782-4878

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200500275NCMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Apr 3, 2021 Accepting new patients
Carolinas Physicians Network Inc Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
Carolinas Medical Center Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Aug 1, 2020 Accepting new patients
Carolinas Physicians Network Inc Orthopaedic Surgery Current Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Orthopaedic Surgery CurrentSince Sep 4, 2020 Accepting new patients
Carolinas Medical Center CurrentSince Aug 1, 2020 Accepting new patients

Locations

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

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

11530 Providence Rd
Ste 1300
Charlotte, NC 28277
Phone (704) 667-0780

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

14214 Ballantyne Lake Rd
Ste 150
Charlotte, NC 28277
Phone (704) 373-1813

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

5735 Prosperity Crossing Dr
Ste 2100
Charlotte, NC 28269

270 Copperfield Blvd NE
Ste 102
Concord, NC 28025
Phone (704) 721-2060

5651 Poplar Tent Rd
Ste 102
Concord, NC 28027
Phone (704) 782-4878

9726 Sam Furr Rd
Huntersville, NC 28078
Phone (704) 801-3310

2700 S Providence Rd
Ste 225
Waxhaw, NC 28173
Phone (704) 667-6700

1690 Highway 160 W
Fort Mill, SC 29708
Phone (803) 547-7541

704 Gold Hill Rd
Ste 203
Fort Mill, SC 29715
Phone (803) 835-0405

Interoperability endpoints

  • Direct secure messaging: ewarren454175@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 10

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 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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1831220292",
    "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": "11530 PROVIDENCE RD",
            "address_2": "STE 1300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282772691",
            "telephone_number": "704-667-0780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5651 Poplar Tent Rd",
            "address_2": "Ste 102",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280277686",
            "country_code": "US",
            "telephone_number": "704-863-4878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5735 Prosperity Crossing Dr",
            "address_2": "STE 2100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282691360",
            "country_code": "US",
            "telephone_number": "704-863-4878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14214 Ballantyne Lake Rd",
            "address_2": "Ste 150",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773372",
            "country_code": "US",
            "telephone_number": "704-863-4878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9726 Sam Furr Rd",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280788218",
            "country_code": "US",
            "telephone_number": "704-863-4878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARREN",
        "first_name": "ERIC",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200500275",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NC",
            "license": "200500275",
            "primary": true
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "NC",
            "license": "200500275",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "200500275",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "200500275",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ewarren454175@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "11530 Providence Rd",
            "address_2": "Ste 1300",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282772691",
            "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.