NPIMap

Individual provider Active NPI

Craig Donald Kolasch, M.D.

  • Surgery Physician
  • Charlotte, NC
National Provider Identifier
1992871693
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2012-01414 Issued in NC
Practice address
325 Hawthorne LN Ste 100
Charlotte, NC 28204-2536
Phone
(704) 316-7760
Fax
(704) 316-7761
NPI assigned
Nov 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Internal Medicine) Physician 207RB0002X 2012-01414 NC
Surgery Physician 208600000X MD428098 PA
Surgery Physician 208600000X 2012-01414 NC Primary

Addresses

Primary practice location

325 Hawthorne LN Ste 100
Charlotte, NC 28204-2536

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-7760

Other practice location 1

2300 Randolph Road
Charlotte, NC 28207-1586
Phone (704) 316-7760

Other identifiers 2

IdentifierTypeStateIssuer
5921090MedicaidNC
NC1647MedicaidSC

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ckolasch78743@direct.novanthealth.org
Direct Messaging Address ckolasch78743@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120905000813 NC Practitioner - General Surgery 2769679497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2001
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, 2,413 clinicians

Practice addresses (Care Compare)

2300 Randolph Rd
Suite a
Charlotte, NC 28207-1586
Phone (704) 316-7760

Hospital & facility affiliations

  • Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Aug 21, 2013 Accepting new patients
Novant Health Medical Group, LLC Obesity Medicine CurrentSince Aug 21, 2013 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Amity Medical Group, Inc. Past Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

325 Hawthorne Ln
Ste 100
Charlotte, NC 28204
Phone (704) 316-7763

13557 Steelecroft Pkwy
Ste 2200
Charlotte, NC 28278
Phone (704) 316-1080

2300 Randolph Rd
Ste A
Charlotte, NC 28207
Phone (704) 372-9393

14215 Ballantyne Corporate Pl
Ste 240
Charlotte, NC 28277

1450 Matthews Township Pkwy
Ste 110
Matthews, NC 28105
Phone (704) 316-7740

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

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

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 1

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": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1992871693",
    "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",
            "telephone_number": "704-316-7760",
            "fax_number": "704-316-7761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 HAWTHORNE LN STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042536",
            "telephone_number": "704-316-7760",
            "fax_number": "704-316-7761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Randolph Road",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282071586",
            "country_code": "US",
            "telephone_number": "704-316-7760",
            "fax_number": "704-316-7761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLASCH",
        "first_name": "CRAIG",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "NC",
            "license": "2012-01414",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD428098",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2012-01414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5921090",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC1647",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckolasch78743@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2300 Randolph Road",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282071586",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckolasch78743@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "325 Hawthorne Ln Ste 100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.