Individual provider Active NPI

Michael J. Bean, MD

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1992864524
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2011-01404 Issued in NC
Practice address
6010 Carnegie Blvd
Charlotte, NC 28209-4637
Phone
(704) 384-9966
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2011-01404 NC Primary

Addresses

Primary practice location

6010 Carnegie Blvd
Charlotte, NC 28209-4637

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

5727 Prosperity Crossing Dr.
suite 1500
Charlotte, NC 28269-2343
Phone (704) 717-2000

Other practice location 2

5727 Prosperity Crossing Dr.
suite 1500
Charlotte, NC 28269-2343
Phone (704) 717-2000

Other practice location 3

4105 Matthews Mint Hill Rd
Matthews, NC 28105-3633
Phone (704) 384-9966

Other practice location 4

10220 Prosperity Park Dr Ste 300
Charlotte, NC 28269-1106
Phone (704) 316-1491

Other identifiers 3

IdentifierTypeStateIssuer
1992864524MedicaidNC
NC2755MedicaidSC
5918789MedicaidMT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mbean245347@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111209000813 NC Practitioner - Pediatric Medicine 9032395587 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
NH Digital Health Services, LLC CurrentSince Sep 1, 2020 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 30, 2018 Accepting new patients
NH Digital Health Services, LLC CurrentSince Sep 1, 2020 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 30, 2018 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients
University Pediatrics Pediatrics PastSince Nov 24, 2019 Accepting new patients

Locations

10220 Prosperity Park Dr
Ste 300
Charlotte, NC 28269
Phone (704) 316-1120

6010 Carnegie Blvd
Charlotte, NC 28209
Phone (704) 384-9966

4105 Matthews Mint Hill Rd
Matthews, NC 28105
Phone (704) 316-3095

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

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

2085 Frontis Plaza Blvd
Winston Salem, NC 27103
Phone (336) 277-7226

Interoperability endpoints

  • Direct secure messaging: mbean245347@direct.novanthealth.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1992864524",
    "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": "6010 CARNEGIE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282094637",
            "telephone_number": "704-384-9966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5727 Prosperity Crossing Dr.",
            "address_2": "suite 1500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282692343",
            "country_code": "US",
            "telephone_number": "704-717-2000",
            "fax_number": "704-863-9741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5727 Prosperity Crossing Dr.",
            "address_2": "suite 1500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282692343",
            "country_code": "US",
            "telephone_number": "704-717-2000",
            "fax_number": "704-863-9741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4105 Matthews Mint Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281053633",
            "country_code": "US",
            "telephone_number": "704-384-9966",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10220 Prosperity Park Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282691106",
            "country_code": "US",
            "telephone_number": "704-316-1491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAN",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2011-01404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992864524",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2755",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5918789",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbean245347@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "5727 Prosperity Crossing Dr.",
            "address_2": "suite 1500",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282692343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.