Individual provider Active NPI

Nicole Fray Rup, MD

  • Physical Medicine & Rehabilitation Physician
  • Concord, NC
National Provider Identifier
1972824472
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
2014-00145 Issued in NC
Practice address
487 Lake Concord Rd NE
Concord, NC 28025-2934
Phone
(704) 403-0300
NPI assigned
Jun 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 2014-00145 NC
Physical Medicine & Rehabilitation Physician 208100000X 2014-00145 NC Primary

Addresses

Primary practice location

487 Lake Concord Rd NE
Concord, NC 28025-2934

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

10648 Park Rd
Charlotte, NC 28210-8407
Phone (704) 355-9330

Other practice location 2

487 Lake Concord Rd NE
Concord, NC 28025-2934
Phone (704) 403-0100

Other practice location 3

10648 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-7070

Other practice location 4

1100 Blythe Blvd
Charlotte, NC 28203-5814
Phone (704) 355-9330

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address nrup288045@CarolinasHealthcareSystem.direct-ci.com Atrium Health

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
I20141002001651 NC Practitioner - Physical Medicine and Rehabilitation 5294955803 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Georgetown University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians
Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000

10628 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-1000

6604 Roberta Rd
Harrisburg, NC 28075-9532
Phone (419) 221-6717

920 Church St N
Concord, NC 28025-2927
Phone (704) 403-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014-00145NCMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Sep 8, 2014 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Medical Center CurrentSince Sep 8, 2014 Accepting new patients
Carolinas Medical Center CurrentSince Sep 8, 2014 Accepting new patients
Carolinas Physicians Network Inc Hospitalist CurrentSince Sep 8, 2014 Accepting new patients
Carolinas Pathology Group, PA Current Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Medical Center Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

10648 Park Rd
Charlotte, NC 28210
Phone (704) 355-9330

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

1100 Blythe Blvd
Charlotte, NC 28203
Phone (704) 355-4300

487 Lake Concord Rd NE
Concord, NC 28025
Phone (704) 403-0100

Interoperability endpoints

  • Direct secure messaging: nrup288045@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 8

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 3

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": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1972824472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "487 LAKE CONCORD RD NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252934",
            "telephone_number": "704-403-0300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10648 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108407",
            "country_code": "US",
            "telephone_number": "704-355-9330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "487 Lake Concord Rd NE",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252934",
            "country_code": "US",
            "telephone_number": "704-403-0100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10648 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108407",
            "country_code": "US",
            "telephone_number": "704-667-7070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Blythe Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035814",
            "country_code": "US",
            "telephone_number": "704-355-9330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUP",
        "first_name": "NICOLE",
        "middle_name": "FRAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-18",
        "last_updated": "2024-07-15",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2014-00145",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NC",
            "license": "2014-00145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nrup288045@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "487 Lake Concord Rd NE",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.