EMERGENT LIFE INTEGRATIVE MEDICINE CENTER, INC (NPI# 1053953125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053953125 |
| Entity Type | Organization |
| Organization Name | EMERGENT LIFE INTEGRATIVE MEDICINE CENTER, INC |
| Practice Address |
5104 Reagan Drive, Suite 4 Charlotte NC 28206-1392 |
| Practice Telephone | 9199612204 |
| Mailing Telephone | 9199612204 |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2019-10-10 |
| Authorized Official Name | BARANY JEGANATTH (FOUNDER, GENERAL MANAGER) |
| Authorized Official Telephone | 9199612204 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| N | 204R00000X | Electrodiagnostic Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
5104 REAGAN DRIVE, SUITE 4 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28206-1392 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861019150 | Novant Medical Group, Inc. | Family Medicine | 2701 Statesville Ave., Charlotte, NC 28206 | 2020-07-02 |
| 1609433291 | Life Interrupted Counseling Services | Counselor | 4045 N Tryon St Ste A, Charlotte, NC 28206 | 2019-05-20 |
| 1295141216 | Taqiyah Camyah Barber | Prosthetic/Orthotic Supplier | 3829 Perennial Terrace Dr, #g, Charlotte, NC 28206 | 2014-07-10 |
| 1386976033 | Olugboyega Remi Fisher | Community Health Worker | 1801 N.tryon Street, Suiteb114, Charlotte, NC 28206 | 2010-02-05 |
| 1821225699 | Alzenia Kelly Morris | Counselor | 1801 N Tryon Street Ste 339, Charlotte, NC 28206 | 2009-06-18 |
| 1942479936 | American Current Care of North Carolina PC | Clinic/Center | 2835 Jeff Adams Drive, Suite A, Charlotte, NC 28206 | 2008-02-25 |
| 1992823629 | Shari J Baum | Preventive Medicine | 2830 North I-85, Suite A and B, Charlotte, NC 28206 | 2007-03-27 |
| 1255479135 | Tameka Denise Jenkins | Counselor | 1600 Norris Ave., Charlotte, NC 28206 | 2007-02-02 |
| 1871655803 | Dwight Hollier | Counselor | 1801 North Tryon Street, Suite 309, Charlotte, NC 28206 | 2006-12-15 |
| 1093213621 | Mishelle L Lockerby | Counselor | 5108 Reagan Dr, Charlotte, NC 28206 | 2018-01-29 |
| Find all providers in zip 28206 | ||||
| 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 |
|---|---|---|---|---|
| 1235745985 | Alegis Care - North Carolina PC | Family Medicine | 11016 Rushmore Dr Ste 300, Charlotte, NC 28277-3651 | 2020-09-18 |
| 1902411077 | Carolina Medical Partners Pllc | Family Medicine | 10535 Flennigan Way, Charlotte, NC 28277-1417 | 2020-09-15 |
| 1083226906 | Relymd Medical Group Nc, Pllc | Family Medicine | 212 S Tryon St Ste 1000, Charlotte, NC 28281-0001 | 2020-08-21 |
| 1861019150 | Novant Medical Group, Inc. | Family Medicine | 2701 Statesville Ave., Charlotte, NC 28206 | 2020-07-02 |
| 1881223139 | Renew Health and Wellness | Family Medicine | 9010 Glenwater Dr Ste 102, Charlotte, NC 28262-8593 | 2020-04-07 |
| 1164052957 | Partners In Integrated Healthcare & Wellness Pllc | Family Medicine | 9414b Albemarle Rd, Charlotte, NC 28227-3346 | 2020-01-21 |
| 1578103636 | Madelyn Laine Eudy | Family Medicine | 15640 Don Lochman Ln Ste A, Charlotte, NC 28277-4793 | 2020-01-07 |
| 1518514686 | L'renda Arkie Adams | Family Medicine | 8724 Bodkin Ct, Charlotte, NC 28215-7356 | 2019-08-22 |
| 1952956419 | Heather Marie Anderson | Family Medicine | 6404 Albemarle Rd Ste J&k, Charlotte, NC 28212-3800 | 2019-08-01 |
| 1003460213 | Companion Health, Pllc | Family Medicine | 5029 Lady Fern Cir, Charlotte, NC 28211-4182 | 2019-07-25 |
| Find all providers in CHARLOTTE | ||||
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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.