Individual provider Active NPI

Jaydev Jani, MD

  • Internal Medicine Physician
  • Concord, NC
National Provider Identifier
1851559942
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2019-01170 Issued in NC
Practice address
200 Medical Park Dr
Ste 550
Concord, NC 28025-2982
Phone
(704) 403-1307
NPI assigned
May 27, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2019-01170 NC Primary

Addresses

Primary practice location

200 Medical Park Dr
Ste 550
Concord, NC 28025-2982

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1237 Harding Pl
Ste 3300
Charlotte, NC 28204
Phone (704) 446-5860

Other practice location 2

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277-3372
Phone (704) 667-2650

Other practice location 3

613 E Roosevelt Blvd
Monroe, NC 28112-5124
Phone (704) 283-8193

Other practice location 4

1090 NE Gateway Ct NE
Ste 202
Concord, NC 28025-2414
Phone (704) 403-9050

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Ambulatory@direct.carolinashealthcare.org Atrium Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, AL2 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
I20190812000950 NC Practitioner - Internal Medicine 7315013000 Reassigns benefits to 2 organizations
I20220428001869 AL Practitioner - Internal Medicine 7315013000 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019-01170NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Apr 3, 2020 Accepting new patients
Archwell Health Professional Services of Alabama, LLC Internal Medicine CurrentSince Jan 25, 2022 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Internal Medicine CurrentSince Apr 3, 2020 Accepting new patients
Archwell Health Professional Services of North Carolina, P.C. Internal Medicine CurrentSince Jan 10, 2022 Accepting new patients

Locations

9174 Roebuck Pkwy E
Birmingham, AL 35206
Phone (205) 498-2675

165 Bessemer Super Hwy
Midfield, AL 35228
Phone (205) 336-1534

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

5740 N Graham St
Charlotte, NC 28269
Phone (704) 251-8340

3022 Eastway Dr
Ste 13
Charlotte, NC 28205
Phone (704) 251-8228

200 Medical Park Dr
Ste 550
Concord, NC 28025
Phone (704) 403-1307

1090 NE Gateway Ct NE
Ste 202
Concord, NC 28025
Phone (704) 403-9050

613 E Roosevelt Blvd
Monroe, NC 28112
Phone (704) 283-8193

102 Woodmont Blvd
Ste 600
Nashville, TN 37205

Interoperability endpoints

  • Direct secure messaging: ambulatory@direct.carolinashealthcare.org

Organizations & group practices 5

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": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1851559942",
    "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": "200 MEDICAL PARK DR",
            "address_2": "STE 550",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252982",
            "telephone_number": "704-403-1307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1237 Harding Pl",
            "address_2": "Ste 3300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28204",
            "country_code": "US",
            "telephone_number": "704-446-5860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14214 Ballantyne Lake Rd",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773372",
            "country_code": "US",
            "telephone_number": "704-667-2650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "613 E Roosevelt Blvd",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "NC",
            "postal_code": "281125124",
            "country_code": "US",
            "telephone_number": "704-283-8193",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1090 NE Gateway Ct NE",
            "address_2": "Ste 202",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252414",
            "country_code": "US",
            "telephone_number": "704-403-9050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANI",
        "first_name": "JAYDEV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-27",
        "last_updated": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2019-01170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ambulatory@direct.carolinashealthcare.org",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "200 Medical Park Dr",
            "address_2": "Ste 550",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.