Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jason Ly, DO

Individual provider Pediatric Emergency Medicine (Pediatrics) Physician · NPI 1649920265

Jason Ly, DO is a Pediatric Medicine in Charlotte, North Carolina. Qualified in 2022, 4 years ago. Works from 2 locations. Licensed in North Carolina and Virginia.

Years since qualifying
4
Licensed in
NC, VA
In the registry since
2022
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1000 Blythe Blvd Fl 4
Charlotte, NC 28203-5812
Phone: (704) 381-6800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 601 Childrens Ln, Norfolk, VA 23507-1910 — (757) 668-7249

Specialties & licences

Pediatric Emergency Medicine (Pediatrics) Physician (primary) Taxonomy 2080P0204X · Licence 2026-01173 (NC)
Pediatric Emergency Medicine (Pediatrics) Physician Taxonomy 2080P0204X · Licence 0102209178 (VA)
Pediatrics Physician Taxonomy 208000000X · Licence 0102209178 (VA)

Record details

NPI number1649920265
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 26, 2022
Last updated in NPPESMarch 19, 2026
Certification dateMarch 19, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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