NPIMap

Individual provider Active NPI

Rajesh Mourya, MBBS

  • Critical Care Medicine (Internal Medicine) Physician
  • Charlotte, NC
National Provider Identifier
1891059929
Registry record updated Jun 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
NA Issued in TN
Practice address
1350 S Kings Dr
Charlotte, NC 28207-2134
Phone
(704) 667-3925
NPI assigned
Jul 3, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 6848 NE
Infectious Disease Physician 207RI0200X 48013 KY
Critical Care Medicine (Internal Medicine) Physician 207RC0200X NA TN Primary

Addresses

Primary practice location

1350 S Kings Dr
Charlotte, NC 28207-2134

Mailing address

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 667-3925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, NC2 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
I20180614001665 AR Practitioner - Critical Care (Intensivists)Practitioner - Infectious Disease 5597071209 Reassigns benefits to 1 organization
I20241029002928 NC Practitioner - Critical Care (Intensivists) 5597071209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians

Practice addresses (Care Compare)

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 355-7328

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6848NEMDInternal Medicine Physician
48013KYMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center CurrentSince Aug 12, 2024 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Jul 15, 2018 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Jul 15, 2018 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Medical Center Critical Care Medicine CurrentSince Aug 12, 2024 Accepting new patients

Locations

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

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

Interoperability endpoints

  • Direct secure messaging: rmourya2907723@carolinashealthcaresystem.direct-ci.com

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.

Hospital & facility affiliations 9

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": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717891200000",
    "number": "1891059929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 S KINGS DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072134",
            "telephone_number": "704-667-3925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S KINGS DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072134",
            "telephone_number": "704-667-3925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOURYA",
        "first_name": "RAJESH",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-03",
        "last_updated": "2024-06-09",
        "certification_date": "2024-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "6848",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "KY",
            "license": "48013",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TN",
            "license": "NA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.