NPIMap

Individual provider Active NPI

David M Grack, PA-C

  • Surgical Physician Assistant
  • Concord, NC
National Provider Identifier
1871599035
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0010-06205 Issued in NC
Practice address
110 Lake Concord Rd NE
Concord, NC 28025-2918
Phone
(704) 792-2672
NPI assigned
Jun 22, 2005
Last updated
Sep 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA002518L PA
Surgical Physician Assistant 363AS0400X 0010-06205 NC Primary

Addresses

Primary practice location

110 Lake Concord Rd NE
Concord, NC 28025-2918

Mailing address

225 Baldwin Ave
Charlotte, NC 28204-3109
Phone (704) 376-1605

Other practice location 1

10314 Hamptons Park Dr
Huntersville, NC 28078-7217
Phone (704) 831-4100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address david.grackpac.p1@direct.cnsa.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160302001399 NC Practitioner - Physician Assistant 1456385723 Reassigns benefits to 2 organizations
I20171030000209 SC Practitioner - Physician Assistant 1456385723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Carolina Neurosurgery and Spine Associates PAGroup PAC ID 7214833375, 104 clinicians
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 clinicians

Practice addresses (Care Compare)

10314 Hamptons Park Dr
Huntersville, NC 28078-7217
Phone (704) 831-4100

110 Lake Concord Rd NE
Concord, NC 28025-2918
Phone (704) 792-2672

225 Baldwin Ave
Charlotte, NC 28204-3109
Phone (704) 376-1605

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

320 Jake Alexander Blvd W
Salisbury, NC 28147-1442
Phone (704) 636-0052

3367 N NC 16 Business Hwy
Denver, NC 28037-8265
Phone (419) 221-6717

937 Riverwalk Pkwy
Rock Hill, SC 29730-0178
Phone (803) 325-1618

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2769SCMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Atrium Health Neurospine Network LLC CurrentSince Oct 1, 2025 Accepting new patients
Atrium Health Neurospine Network LLC CurrentSince Oct 1, 2025 Accepting new patients
Regional Health Services Inc Past Accepting new patients
Carolina Neurosurgery, PA Past Accepting new patients

Locations

225 Baldwin Ave
Charlotte, NC 28204
Phone (704) 376-1605

110 Lake Concord Rd NE
Concord, NC 28025
Phone (704) 792-2672

10314 Hamptons Park Dr
Huntersville, NC 28078
Phone (704) 831-4100

937 Riverwalk Pkwy
Rock Hill, SC 29730
Phone (803) 325-1618

937 Riverwalk Pkwy
Ste 101
Rock Hill, SC 29730
Phone (800) 344-6716

Interoperability endpoints

  • Direct secure messaging: david.grackpac.p1@direct.cnsa.nextgenshare.com
  • Direct secure messaging: dgrack499504@carolinashealthcaresystem.direct-ci.com
  • FHIR API: https://epicproxy.et0905.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

Hospital & facility affiliations 12

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1871599035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 BALDWIN AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043109",
            "telephone_number": "704-376-1605",
            "fax_number": "704-376-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LAKE CONCORD RD NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252918",
            "telephone_number": "704-792-2672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10314 Hamptons Park Dr",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787217",
            "country_code": "US",
            "telephone_number": "704-831-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRACK",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA002518L",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-06205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "david.grackpac.p1@direct.cnsa.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "225 Baldwin Ave",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.