Charnette H Shade, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

200400745 Issued in NC

Practice address

91 Enterprise Dr
Rocky Mount, NC 27804-9590

Phone

(252) 451-3100

Fax

(252) 937-3106

NPI assigned

Sep 8, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charnette.shade@bwc.eclinicaldirectplus.com

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.

• Boice-Willis Clinic PA

  • Internal Medicine Physician
  • Rocky Mount, NC
  • NPI 1699722389

  Pediatrics

  Medicare reassignment NPD
• Boice-Willis Clinic, PA

  • Physical Therapy Clinic/Center
  • Rocky Mount, NC
  • NPI 1952557241
  NPD

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1942294764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7200",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278040200",
            "telephone_number": "252-937-0200",
            "fax_number": "252-451-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 ENTERPRISE DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278049590",
            "telephone_number": "252-451-3100",
            "fax_number": "252-937-3106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Nash Medical Arts Mall",
            "address_purpose": "LOCATION",
            "city": "Rocky Mount",
            "state": "NC",
            "postal_code": "278041400",
            "country_code": "US",
            "telephone_number": "252-451-3100",
            "fax_number": "252-937-3106",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "921 N Winstead Ave",
            "address_purpose": "LOCATION",
            "city": "Rocky Mount",
            "state": "NC",
            "postal_code": "278048749",
            "country_code": "US",
            "telephone_number": "252-937-0300",
            "fax_number": "252-937-3108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHADE",
        "first_name": "CHARNETTE",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-08",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200400745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "9568009",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D5324",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1902525",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "137AJ",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89137AJ",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teri Sears
• Second Chance Recovery
• Travella A Sellers, DPM
• Serenity Family Care and Consulting Services
• Serving Hands, LLC
• Shilvi Sunil Shah, DDS
• Shannon Brackett Hinkle, PA-C, PLLC
• Mehrzad Shariff, RPH
• Jarika Sharpe, MSW, LCSW
• Jacqueline Shaw, LPC

• Pediatrics Physician in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.