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SMITH FAMILY WELLNESS CLINIC
NPI 1053065201
Clinic/Center - Federally Qualified Health Center (FQHC) in Charlotte, NC

Active since February 07, 2022CLIA 34D1054068 · Microscopy
3622 CENTRAL AVE, CHARLOTTE, NC 28205(704) 316-6561(704) 384-1977 Get Directions Write a Review

NPPES record last updated: August 15, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 15, 2022, Aug 10, 2022, Feb 7, 2022 (3 updates tracked since 2022).

About Smith Family Wellness Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SMITH FAMILY WELLNESS CLINIC (NPI 1053065201) is a healthcare organization registered as a federally qualified health center (fqhc) in Charlotte, North Carolina and active in the NPI registry since February 2022. The organization holds a CLIA Microscopy certificate valid through February 5, 2027 and lists Stefani Priscilia Ruarte, Credentialing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1053065201
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameCHARLOTTE COMMUNITY HEALTH CLINIC, INC.
Location Address3622 CENTRAL AVECharlotte, NC 28205-5638
Mailing Address8401 Medical Plaza Dr Ste 300Charlotte, NC 28262-8702 · (704) 316-6561 · Fax (704) 384-1977
Phone(704) 316-6561
Fax(704) 384-1977
Organization SubpartNo
Authorized OfficialStefani Priscilia RuarteCredentialing Coordinator · (704) 316-6573
Enumeration DateFebruary 7, 2022
Last NPPES UpdateAugust 15, 20223 updates tracked since enumeration
NPPES CertifiedAugust 15, 2022
✔ NPI 1053065201 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
3622 CENTRAL AVE, Charlotte, NC 28205
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Other Names 1

Other NameSmith Family Wellness Clinic

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Smith Family Wellness Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

29

Medicare enrollment records show 29 clinicians reassign Medicare billing to Smith Family Wellness Clinic, which bills Medicare for the services they deliver. Of these, 17 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 6

Nurse Practitioner9
Dentist7
Clinical Social Worker4
Pediatric Medicine4
Family Practice3
Internal Medicine2

Nearest to this location (20)

See all 29
Lisa Langley, FNP
Nurse Practitioner
NPI 1457693426
501 BILLINGSLEY RD COTTAGE B
Charlotte, NC 28211
(704) 444-5881
✔ PECOS2.0 mi
Victor Perry, DMD
Dentist
NPI 1720660483
6316 E INDEPENDENCE BLVD
Charlotte, NC 28212
(980) 265-3180
✔ PECOS3.5 mi
Sveta Mohanan, MD
Family Practice
NPI 1316023336
1801 ROZZELLES FERRY RD
Charlotte, NC 28208
(704) 446-9987
✔ PECOS✔ Accepts Medicare4.7 mi
Shatamra Jackson, MSW
Clinical Social Worker
NPI 1255929253
5200 PARK RD
Charlotte, NC 28209
(270) 535-5882
✔ PECOS5.4 mi
Jonathan Butler, MD, M.ED.
Family Practice
NPI 1386753325
8401 MEDICAL PLAZA DR STE 300
Charlotte, NC 28262
(704) 316-6561
✔ PECOS✔ Accepts Medicare7.2 mi
Hilary Canipe, MD
Family Practice
NPI 1225059884
8401 MEDICAL PLAZA DR STE 300
Charlotte, NC 28262
(704) 316-6561
✔ PECOS✔ Accepts Medicare7.2 mi
Nga Tran, MD
Pediatric Medicine
NPI 1043847049
8401 MEDICAL PLAZA DR STE 300
Charlotte, NC 28262
(704) 316-6574
✔ PECOS7.2 mi
Lashandra Duncan, DNP, FNP-BC,PMHNP-BC
Nurse Practitioner
NPI 1255679049
8401 MEDICAL PLAZA DR STE 300
Charlotte, NC 28262
(704) 316-6561
✔ PECOS7.2 mi
Rosa Medina, FNP-C
Nurse Practitioner
NPI 1689454241
8401 MEDICAL PLAZA DR STE 300
Charlotte, NC 28262
(704) 316-6561
✔ PECOS✔ Accepts Medicare7.2 mi
Rachael Pennell, MSW, LCSW-A
Clinical Social Worker
NPI 1285087031
8401 MEDICAL PLAZA DR STE 300
Charlotte, NC 28262
(704) 316-6561
✔ PECOS7.2 mi
Brittanie Height, DMD
Dentist
NPI 1427794775
5301 WILKINSON BLVD
Charlotte, NC 28208
(704) 384-1882
✔ PECOS8.2 mi
Amy Spencer, DNP, NP-C
Nurse Practitioner
NPI 1821342536
5301 WILKINSON BLVD
Charlotte, NC 28208
(704) 316-6561
✔ PECOS✔ Accepts Medicare8.2 mi
Heather Bartlett, LCSW
Clinical Social Worker
NPI 1003554411
5301 WILKINSON BLVD
Charlotte, NC 28208
(704) 316-6561
✔ PECOS8.2 mi
Raymond Tah, FNP
Nurse Practitioner
NPI 1518482710
9159 PERSEVERANCE DR
Harrisburg, NC 28075
(786) 302-6062
✔ PECOS✔ Accepts Medicare8.9 mi
Janelle White, MD
Pediatric Medicine
NPI 1932237831
101 E W T HARRIS BLVD STE 1121
Charlotte, NC 28262
(704) 717-2000
✔ PECOS9.2 mi
Alagusivakumari Rameshbabu, MD
Internal Medicine
NPI 1003850389
10648 PARK RD
Charlotte, NC 28210
(704) 667-8050
✔ PECOS9.8 mi
Trang Tran
Dentist
NPI 1437728268
8020 NORTHLAKE W DR
Charlotte, NC 28216
(704) 264-1441
✔ PECOS10.0 mi
Andrea Rice, MD
Pediatric Medicine
NPI 1801962246
7752 GATEWAY LN NW STE 100
Concord, NC 28027
(704) 316-4950
✔ PECOS11 mi
Harold Zeltner, MD
Internal Medicine
NPI 1508955980
6030 W. HIGHWAY 74, SUITE D
Indian Trail, NC 28079
(704) 316-6561
✔ PECOS✔ Accepts Medicare13 mi
Tashana Detwiler, DMD
Dentist
NPI 1205500147
280 CONCORD PKWY S STE 110A
Concord, NC 28027
(704) 920-1070
✔ PECOS16 mi
See all 29 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 34D1054068

Charlotte Community Health Clinic · Charlotte, NC
Active · expires Feb 5, 2027
CLIA Number34D1054068
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateFebruary 6, 2025
Certificate Expiration DateFebruary 5, 2027
Laboratory DirectorSveta Mohanan
Laboratory Phone(704) 384-0422
Laboratory LocationCharlotte Community Health Clinic8401 Medical Plaza Drive, Charlotte, NC 28205
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charlotte Community Health Clinic, Inc.'s NPI number?

The NPI number for Charlotte Community Health Clinic, Inc. is 1053065201. It was assigned to this organization in the NPPES registry on February 7, 2022. The provider is also known as Smith Family Wellness Clinic.

Where is Charlotte Community Health Clinic, Inc. located?

Charlotte Community Health Clinic, Inc. is located at 3622 Central Ave, Charlotte, NC 28205. The listed phone number is (704) 316-6561.

What is Charlotte Community Health Clinic, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Is Charlotte Community Health Clinic, Inc. enrolled in Medicare?

Yes. Charlotte Community Health Clinic, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Charlotte Community Health Clinic, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 29 clinicians in 6 Medicare specialties reassign their Medicare billing to Charlotte Community Health Clinic, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (9), Dentist (7) and Clinical Social Worker (4). Of these, 17 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Charlotte Community Health Clinic, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 34D1054068) is associated with this NPI, valid through February 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Charlotte Community Health Clinic, Inc. accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and Blue Cross and Blue Shield of NC and 2 other insurers list Charlotte Community Health Clinic, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Charlotte Community Health Clinic, Inc. was last updated on August 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.