INDIAN TRAIL FAMILY MEDICINE (NPI# 1003842782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003842782 |
| Entity Type | Organization |
| Organization Name | INDIAN TRAIL FAMILY MEDICINE |
| Practice Address |
4503 Old Monroe Rd Indian Trail NC 28079-5309 |
| Mailing Address |
5000 Airport Center Pkwy Ste A Charlotte NC 28208-5899 |
| Practice Telephone | 7048216900 |
| Practice Fax Number | 7048216911 |
| Mailing Telephone | 7045124116 |
| Mailing Fax Number | 7043717284 |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2008-02-12 |
| Authorized Official Name | DANIEL L WIENS (SENIOR VICE PRESIDENT) |
| Authorized Official Telephone | 7043550648 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7901052 | 05 |
| Street Address |
4503 OLD MONROE RD |
| City | INDIAN TRAIL |
| State | NC |
| Zip Code | 28079-5309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487261327 | Nicole Katharine Straker | Nurse Practitioner | 4503 Old Monroe Rd, Indian Trail, NC 28079-5309 | 2020-09-24 |
| 1063815827 | Robyn Gonzales | Nurse Practitioner | 4503 Old Monroe Rd, Indian Trail, NC 28079-5309 | 2014-10-07 |
| 1447596259 | Carolinas Physicians Network, Inc. | Internal Medicine | 4503 Old Monroe Rd, Suite A, Indian Trail, NC 28079-5309 | 2012-12-26 |
| 1134474059 | Carolinas Physicians Network Inc | Family Medicine | 4503 Old Monroe Rd, Indian Trail, NC 28079-5309 | 2012-07-17 |
| 1063731453 | Tina Lovings | Nurse Practitioner | 4503 Old Monroe Rd, Indian Trail, NC 28079-5309 | 2010-05-25 |
| 1306904255 | Timothy Kennard | Family Medicine | 4503 Old Monroe Rd, Indian Trail, NC 28079-5309 | 2006-12-04 |
| 1043386766 | Union Physicians Network Inc | Family Medicine | 4503 Old Monroe Rd, Indian Trail, NC 28079-5309 | 2006-11-27 |
| 1669486288 | Donald Eugene Cook | Family Medicine | 4503 Old Monroe Rd, Indian Trail, NC 28079-5309 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992297485 | Carolina Cala | Community/Behavioral Health | 3817 Balsam St, Indian Trail, NC 28079 | 2018-05-31 |
| 1992294805 | Dr Patel & Associates, Pa | Clinic/Center | 6046 W Highway 74, Indian Trail, NC 28079 | 2018-05-07 |
| 1306389085 | Creative Counseling and Consulting, LLC | Counselor | 4389 Indian Trail-fairview Road, Indian Trail, NC 28079 | 2016-11-29 |
| 1922481381 | Aakar Gaurang Chokshi | Dentist | 5850 W Highway 74 Ste 135, Indian Trail, NC 28079 | 2015-07-02 |
| 1881944536 | Francy Johana Rodriguez | Naturopath | 124 Unionville Indian Trail Rd W Ste A9, Indian Trail, NC 28079 | 2012-09-10 |
| 1669767653 | Leigh Ann Zimmerman Tasillo | Psychologist | 124 Unionville-indian Trail Rd., Suite B3, Indian Trail, NC 28079 | 2011-06-17 |
| 1679715650 | Indian Trail Chiropractic & Rehabilitation, Pa | Chiropractor | 100 Park Road East, Indian Trail, NC 28079 | 2009-04-06 |
| 1003079518 | Shemeeka L Mcfadden | Optometrist | 5850 Us-74, Unit 116, Indian Trail, NC 28079 | 2008-07-03 |
| 1023290046 | Gary Lee Vaughn | Technician/Technologist | 622 Indian Trail Rd, Indian Trail, NC 28079 | 2007-11-30 |
| 1750574331 | Susana C Junco | Dentist | 136 Indian Trail Rd, Indian Trail, NC 28079 | 2007-08-27 |
| Find all providers in zip 28079 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902209539 | Carolina Medicorp Enterprises, Inc | Family Medicine | 622 Indian Trail Rd S, Indian Trail, NC 28079-9680 | 2014-09-26 |
| 1518047539 | George S. C. Tsai | Family Medicine | 301 South Indian Trail Road, Indian Trail, NC 28079-0430 | 2006-10-16 |
| 1306860580 | Douglas Chen | Family Medicine | 6208 Creft Cir, Ste 222, Indian Trail, NC 28079-9003 | 2006-07-27 |
| 1922046929 | Novant Medical Group, Inc | Family Medicine | 1480 Wesley Chapel Rd, Indian Trail, NC 28079-5244 | 2006-06-02 |
| 1164739850 | Hina Tahir | Family Medicine | 1480 Wesley Chapel Rd, Indian Trail, NC 28079-5244 | 2010-09-02 |
| 1609014133 | Onyinye Igbokwe | Family Medicine | 1480 Wesley Chapel Rd, Indian Trail, NC 28079-5244 | 2009-01-21 |
| 1902004187 | Lauren Jones | Family Medicine | 6030 W Highway 74, Ste A, Indian Trail, NC 28079-3468 | 2007-07-10 |
| 1306904255 | Timothy Kennard | Family Medicine | 4503 Old Monroe Rd, Indian Trail, NC 28079-5309 | 2006-12-04 |
| 1043386766 | Union Physicians Network Inc | Family Medicine | 4503 Old Monroe Rd, Indian Trail, NC 28079-5309 | 2006-11-27 |
| 1578572939 | Union Physicians Network Inc | Family Medicine | 6208 Creft Cir, Suite 222, Indian Trail, NC 28079-9003 | 2006-08-05 |
| Find all providers in INDIAN TRAIL | ||||
| City | INDIAN TRAIL |
| Zip Code | 28079 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.