NPIMap

Organization Active NPI

Chma of NC

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1982364469
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CHMA OF NC
Practice address
6047 Tyvola Glen Cir Ste 100
Charlotte, NC 28217-6431
Phone
(443) 383-9300
Fax
(855) 866-8710
NPI assigned
Dec 23, 2021
Last updated
May 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Authorized official

Name
Matt Welik
Title
Ceo
Phone
(443) 383-9300

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NU
Internal Medicine Physician 207R00000X NU Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

6047 Tyvola Glen Cir Ste 100
Charlotte, NC 28217-6431

Mailing address

909 Ridgebrook Rd Ste 300
Sparks, MD 21152-9477
Phone (443) 383-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220203000311 NC Part B Supplier - Clinic/Group Practice 5092108605 Receives reassigned benefits from 47 practitioners
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 70

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 70

NPI Registry JSON

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

{
    "created_epoch": "1640217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1982364469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 RIDGEBROOK RD STE 300",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529477",
            "telephone_number": "443-383-9300",
            "fax_number": "855-866-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6047 TYVOLA GLEN CIR STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282176431",
            "telephone_number": "443-383-9300",
            "fax_number": "855-866-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHMA OF NC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-23",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "WELIK",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-383-9300"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.