Individual provider Active NPI

Stephanie Michelle Becker, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1992167753
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-09225 Issued in NC
Practice address
125 Queens Rd Ste 250
Charlotte, NC 28204-3215
Phone
(704) 316-5100
Fax
(704) 316-5101
NPI assigned
Mar 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Physician Assistant 363A00000X 0010-09225 NC Primary

Addresses

Primary practice location

125 Queens Rd Ste 250
Charlotte, NC 28204-3215

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

2750 Clay Edwards Dr
Suite 304
North Kansas City, MO 64116-3237
Phone (816) 842-5555

Other practice location 2

301 Hawthorne Ln Ste 200
Charlotte, NC 28204-2467
Phone (704) 316-5100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sbecker816839@direct.novanthealth.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200720001915 NC Practitioner - Physician Assistant 9133411721 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

125 Queens Rd
Charlotte, NC 28204-3215

15830 Ballantyne Medical PL
Suite 275
Charlotte, NC 28277-4791
Phone (980) 302-8659

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 343-9800

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Presbyterian Hospital CurrentSince Jul 16, 2020 Accepting new patients
Novant Medical Group Inc CurrentSince Jul 16, 2020 Accepting new patients
The Presbyterian Hospital CurrentSince Jul 16, 2020 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 16, 2020 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 16, 2020 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

125 Baldwin Ave
Ste 200
Charlotte, NC 28204
Phone (704) 384-5043

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

301 Hawthorne Ln
Ste 200
Charlotte, NC 28204
Phone (704) 316-5100

125 Queens Rd
Ste 250
Charlotte, NC 28204
Phone (704) 316-2340

125 Queens Rd
Ste 200
Charlotte, NC 28204

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: sbecker816839@direct.novanthealth.org

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 4

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": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1992167753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD STE 250",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043215",
            "telephone_number": "704-316-5100",
            "fax_number": "704-316-5101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2750 Clay Edwards Dr",
            "address_2": "Suite 304",
            "address_purpose": "LOCATION",
            "city": "North Kansas City",
            "state": "MO",
            "postal_code": "641163237",
            "country_code": "US",
            "telephone_number": "816-842-5555",
            "fax_number": "816-659-9123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Hawthorne Ln Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042467",
            "country_code": "US",
            "telephone_number": "704-316-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BECKER",
        "first_name": "STEPHANIE",
        "middle_name": "MICHELLE",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbecker816839@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "125 Queens Rd Ste 250",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.