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JENNIFER STATIS MD
NPI 1275562571
Pediatrics in Charlotte, NC

Active since July 01, 2006PECOS Enrolled
6025 BLAKENEY PARK DR, STE 100, CHARLOTTE, NC 28277(704) 667-4480 Get Directions Write a Review

NPPES record last updated: April 20, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 20, 2020, Mar 2, 2020, Feb 17, 2020 and 34 more (37 updates tracked since 2016).

About Jennifer Statis Md NPPES

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

JENNIFER STATIS MD (NPI 1275562571) is an individual pediatrics provider in Charlotte, North Carolina, licensed in North Carolina (2006-00781) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1275562571
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameJENNIFER STATISCredential: MD
Location Address6025 BLAKENEY PARK DR, STE 100Charlotte, NC 28277-5703
Mailing AddressPo Box 19305Charlotte, NC 28219-9305
Phone(704) 667-4480
Sole ProprietorNo
Enumeration DateJuly 1, 2006
Last NPPES UpdateApril 20, 202037 updates tracked since enumeration
✔ NPI 1275562571 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NC · 2006-00781
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
6025 BLAKENEY PARK DR, Charlotte, NC 28277
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Secondary Practice Locations 4

Location 17810 Providence Rd, Ste 102Charlotte, NC 28226-2954 · Phone (704) 543-6636
Location 25727 Prosperity Crossing Dr, Ste 1100Charlotte, NC 28269-2206 · Phone (704) 863-9930
Location 35717 Albemarle RdCharlotte, NC 28212-1634 · Phone (704) 563-2150
Location 410210 Couloak Dr, Ste ECharlotte, NC 28216-7679 · Phone (704) 801-2000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer Statis Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Jennifer Statis reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Carolinas Physicians Network Inc
Same address
Family Medicine
6025 BLAKENEY PARK DR, STE 100
Charlotte, NC 28277
  • Reassigned Medicare billing, North Carolina enrollment
  • 2,057 clinicians in this Medicare group
NPI 1285995415 (704) 667-4480
Arboretum Urgent Care Center
5.0 mi
Family Medicine
7810 PROVIDENCE RD, STE 102
Charlotte, NC 28226
  • Reassigned Medicare billing, North Carolina enrollment
  • 157 clinicians in this Medicare group
NPI 1457380313 (704) 543-6636

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28277 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMY LYNN GREGORY NP
Nurse Practitioner
6025 BLAKENEY PARK DR, STE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 667-4480
DR. KAREN SHELTON PH.D.
Psychologist (Clinical Child & Adolescent)
6025 BLAKENEY PARK DR, SUITE 120
CHARLOTTE, NC 28277
Mecklenburg County (704) 973-4444
EXPECT SUCCESS INC
Counselor (Mental Health)
6025 BLAKENEY PARK DR, SUITE 120
CHARLOTTE, NC 28277
Mecklenburg County (704) 831-6841
LAURA SINAI
Pediatrics
6025 BLAKENEY PARK DR, SUITE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 667-4480
CAROLINAS PHYSICIANS NETWORK INC
Family Medicine
6025 BLAKENEY PARK DR, STE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 667-4480
JUMANA SHEBIB SCOGGINS LPC
Counselor (Professional)
6025 BLAKENEY PARK DR, SUITE 120
CHARLOTTE, NC 28277
Mecklenburg County (704) 277-7157
MR. PETER GERALD MCGOURTY LPC
Counselor (Mental Health)
6025 BLAKENEY PARK DR, SUITE 120
CHARLOTTE, NC 28277
Mecklenburg County (704) 831-6841
ROBERT SCHAFERMEYER
Pediatrics (Pediatric Emergency Medicine)
6025 BLAKENEY PARK DR, SUITE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 667-4480

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 Jennifer Statis's NPI number?

The NPI number for Jennifer Statis is 1275562571. It was assigned to this individual provider in the NPPES registry on July 1, 2006.

Where is Jennifer Statis located?

Jennifer Statis practices at 6025 Blakeney Park Dr Ste 100, Charlotte, NC 28277. The listed phone number is (704) 667-4480.

What is Jennifer Statis's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Jennifer Statis enrolled in Medicare?

Yes. Jennifer Statis is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jennifer Statis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Statis reassigns Medicare benefits to 2 organizations: Carolinas Physicians Network Inc (Charlotte, NC) and Arboretum Urgent Care Center (Charlotte, NC). Each 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 Jennifer Statis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jennifer Statis was last updated on April 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.