Individual provider Active NPI

Charles David Anderson, MD

  • Pediatric Nephrology Physician
  • Charlotte, NC
National Provider Identifier
1891256632
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
2022-01502 Issued in NC
Practice address
1001 Blythe Blvd Ste 200
Charlotte, NC 28203-5865
Phone
(704) 381-8840
NPI assigned
Mar 26, 2019
Last updated
Aug 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X 2022-01502 NC Primary

Addresses

Primary practice location

1001 Blythe Blvd Ste 200
Charlotte, NC 28203-5865

Mailing address

1001 Blythe Blvd Ste 200
Charlotte, NC 28203-5865
Phone (704) 381-8840

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
I20220823002905 NC Practitioner - Pediatric Medicine 7517294010 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022-01502NCMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center Pediatrics Current Accepting new patients
Carolinas Medical Center Pediatrics CurrentSince Jul 1, 2022 Accepting new patients
Carolinas Medical Center CurrentSince Jul 1, 2022 Accepting new patients

Locations

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

1000 Blythe Blvd
Fl 4
Charlotte, NC 28203
Phone (704) 355-8188

1001 Blythe Blvd
Ste 200
Charlotte, NC 28203
Phone (704) 373-0544

1001 Blythe Blvd
Ste 500
Charlotte, NC 28203
Phone (704) 355-5100

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1891256632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BLYTHE BLVD STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035865",
            "telephone_number": "704-381-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BLYTHE BLVD STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035865",
            "telephone_number": "704-381-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CHARLES",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-26",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "NC",
            "license": "2022-01502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.