Individual provider Active NPI

Carolina Fasola, M.D., M.P.H.

  • Radiation Oncology Physician
  • Charlotte, NC
National Provider Identifier
1922346923
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
A121732 Issued in CA
Practice address
200 Queens Rd
Suite 400
Charlotte, NC 28204-3253
Phone
(704) 333-7376
NPI assigned
Jan 25, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X A121732 CA Primary
Radiation Oncology Physician 2085R0001X 2015-00752 NC
Radiation Oncology Physician 2085R0001X 38102 SC

Addresses

Primary practice location

200 Queens Rd
Suite 400
Charlotte, NC 28204-3253

Mailing address

200 Queens Rd
Suite 400
Charlotte, NC 28204-3253
Phone (704) 333-7376

Other identifiers 2

IdentifierTypeStateIssuer
NC2449MedicaidSC
1922346923MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 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
I20150910003013 SC Practitioner - Radiation Oncology 3173830999 Reassigns benefits to 1 organization
I20150910003044 NC Practitioner - Radiation Oncology 3173830999 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Emory University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Radiation Oncology Group, P.a.Group PAC ID 1254233950, 52 clinicians

Practice addresses (Care Compare)

200 Queens Rd
Charlotte, NC 28204-3264
Phone (704) 333-7376

301 Yadkin St
Albemarle, NC 28001-3441
Phone (704) 333-7376

920 Church N St
Concord, NC 28025-2927
Phone (704) 333-7376

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38102SCMDPharmacist
A121732CAMDRadiation Oncology Physician
2015-00752NCMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiation Oncology Centers of the Carolinas, Inc. Radiation Oncology CurrentSince Aug 17, 2015 Accepting new patients
Southeast Radiation Oncology Group, P.a. Radiation Oncology CurrentSince Aug 17, 2015 Accepting new patients
Piedmont Carolinas Radiation Therapy LLC CurrentSince Aug 17, 2015 Accepting new patients
Piedmont Carolinas Radiation Therapy LLC CurrentSince Aug 17, 2015 Accepting new patients

Locations

200 Queens Rd
Ste 400
Charlotte, NC 28204
Phone (704) 765-2578

1021 Morehead Medical Dr
Charlotte, NC 28204
Phone (704) 355-2272

1400 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 845-8800

170 Medical Park Rd
Ste 100
Mooresville, NC 28117
Phone (704) 235-2580

1005 W Meeting St
Lancaster, SC 29720
Phone (803) 283-6200

228 Herlong Ave S
Rock Hill, SC 29732
Phone (803) 366-5186

Interoperability endpoints

  • Direct secure messaging: cfasola136629@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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 6

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": "1359072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1922346923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 QUEENS RD",
            "address_2": "SUITE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043253",
            "telephone_number": "704-333-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 QUEENS RD",
            "address_2": "SUITE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043253",
            "telephone_number": "704-333-7376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASOLA",
        "first_name": "CAROLINA",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-25",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "A121732",
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NC",
            "license": "2015-00752",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "SC",
            "license": "38102",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2449",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922346923",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.