MECKLENBURG MEDICAL GROUP (NPI# 1114242088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114242088 |
| Entity Type | Organization |
| Organization Name | MECKLENBURG MEDICAL GROUP |
| Practice Address |
1025 Morehead Medical Drive Suite 200 Charlotte NC 28204-2965 |
| Mailing Address |
Po Box 60063 Charlotte NC 28260-0063 |
| Practice Telephone | 7043028000 |
| Practice Fax Number | 7043028001 |
| Mailing Telephone | 7043028000 |
| Mailing Fax Number | 7043028001 |
| Enumeration Date | 2010-04-02 |
| Last Update Date | 2010-04-02 |
| 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 | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669797536 | Mecklenburg Medical Group | Internal Medicine | 16455 Statesville Road, Suite 200, Huntersville, NC 28078-7125 | 2010-04-02 |
| 1518282581 | Mecklenburg Medical Group | Internal Medicine | 7666 Charlotte Highway, Suite 200, Indian Land, SC 29707-7001 | 2010-04-02 |
| 1831414705 | Mecklenburg Medical Group | Internal Medicine | 10650 Park Road Extension, Suite 420, Charlotte, NC 28210-8539 | 2010-04-02 |
| 1780909101 | Mecklenburg Medical Group | Internal Medicine | 15110 John J Delaney Drive, Suite 200, Charlotte, NC 28277-3545 | 2010-03-29 |
| 1629305073 | Mecklenburg Medical Group | Internal Medicine | 13640 Steelecroft Parkway, Suite 320, Charlotte, NC 28278-7565 | 2009-11-05 |
| 1477879260 | Mecklenburg Medical Group | Dermatology | 4525 Cameron Valley Pkwy, Suite 2100, Charlotte, NC 28211-4369 | 2010-04-19 |
| 1821314618 | Mecklenburg Medical Group | Internal Medicine | 200 South College Street, Suite 500, Charlotte, NC 28202-2067 | 2010-04-19 |
| 1093031882 | Mecklenburg Medical Group | Internal Medicine | 16455 Statesville Rd, Ste 200, Huntersville, NC 28078-7135 | 2010-04-19 |
| 1457677247 | Mecklenburg Medical Group | Dermatology | 1900 Brunswick Ave, Charlotte, NC 28207-1822 | 2010-04-19 |
| 1366768152 | Mecklenburg Medical Group | Dermatology | 1025 Morehead Medical Drive, Suite 200, Charlotte, NC 28204-2965 | 2010-04-19 |
| Street Address |
1025 MOREHEAD MEDICAL DRIVE SUITE 200 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28204-2965 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053375170 | Kelly L Vanderhave | Orthopaedic Surgery | 1025 Morehead Medical Drive, Suite 300, Charlotte, NC 28204-2966 | 2006-04-14 |
| 1972149946 | Christoph Tschuor | Surgery | 1025 Morehead Medical Drive, Suite 600, Charlotte, NC 28204 | 2019-11-25 |
| 1720644354 | Eva Barbara Deerenberg | Surgery | 1025 Morehead Medical Drive, Suite 300, Charlotte, NC 28204 | 2019-05-20 |
| 1306223425 | Daphne Louise Capek | Obstetrics & Gynecology | 1025 Morehead Medical Drive, Suite 450, Charlotte, NC 28204 | 2015-04-27 |
| 1528455243 | Patrick Moody | Orthopaedic Surgery | 1025 Morehead Medical Drive, Suite 300, Charlotte, NC 28204-2966 | 2015-04-21 |
| 1366768152 | Mecklenburg Medical Group | Dermatology | 1025 Morehead Medical Drive, Suite 200, Charlotte, NC 28204-2965 | 2010-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285263582 | Precise Home Care Service LLC | In Home Supportive Care | 1935 Baxter Street, Unit 101, Charlotte, NC 28204 | 2020-04-07 |
| 1285276253 | Shannon Miller | Counselor | 1432 E Seventh Street, Charlotte, NC 28204 | 2019-10-11 |
| 1194282202 | Madison Joann Mcgarrigle | Behavior Technician | 1401 East 7th Street, Charlotte, NC 28204 | 2019-02-25 |
| 1255802674 | Stacey D. Alston, Dds, Pa | Dentist | 1020 E. 10th St., Suite 1, Charlotte, NC 28204 | 2018-12-11 |
| 1972082097 | Kim Webb Talbert | Nurse Practitioner | Novant Health Presbyterian Medical Center Charlotte, 200 Hawthorne Lane, Charlotte, NC 28204 | 2018-08-09 |
| 1164910535 | Jesse Elijah Roberts | Counselor | 1801 E 5th Street, #208, Charlotte, NC 28204 | 2018-05-01 |
| 1336696848 | Eight Healthcare | Exclusive Provider Organization | 2455 Weddington Ave, 2110, Charlotte, NC 28204 | 2016-09-01 |
| 1225480551 | Kathleen Quintana Bradley | Physician Assistant | 1523 Elizabeth Ave., Suite 200, Charlotte, NC 28204 | 2016-07-11 |
| 1184049777 | Della Franklin | Speech-Language Pathologist | 1021 Morehead Medical Dr Ste 3300, Charlotte, NC 28204 | 2014-02-19 |
| 1225459845 | Healing Arts Medical, Pa | Family Medicine | 335 N. Caswell Rd., Charlotte, NC 28204 | 2013-12-27 |
| Find all providers in zip 28204 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932722980 | Carolinas Physicians Network Inc | Internal Medicine | 2041 South Blvd, Ste 100, Charlotte, NC 28203-5062 | 2020-05-26 |
| 1538700745 | Geriatric Care of The Carolinas, Pllc | Internal Medicine | 6001 Graburns Ford Dr, Charlotte, NC 28269-7120 | 2019-09-30 |
| 1477100683 | Carolinas Physicians Network Inc | Internal Medicine | 9325 Jw Clay Blvd, Ste 221, Charlotte, NC 28262-5411 | 2019-08-22 |
| 1972169977 | Iora Health North Carolina, P.C. | Internal Medicine | 8332 Pineville Matthews Rd Ste 205, Charlotte, NC 28226-3765 | 2019-05-15 |
| 1700345105 | Carolinas Physicians Network Inc | Internal Medicine | 2109 Randolph Rd, Charlotte, NC 28207-1521 | 2019-03-15 |
| 1790256964 | Tele Phys Inc | Internal Medicine | 10035 Park Center Dr., Ste 100, Charlotte, NC 28210 | 2018-12-16 |
| 1053880518 | Low-t Physicians Professional Association | Internal Medicine | 10430 Park Road Suite 100a, Charlotte, NC 28210 | 2018-11-14 |
| 1033698527 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 304, Charlotte, NC 28215 | 2018-08-07 |
| 1588166060 | Allcare Medical Center,pllc | Internal Medicine | 7401 The Plaza, Charlotte, NC 28215 | 2018-03-01 |
| 1083137616 | Sc Med LLC | Internal Medicine | 10436 Winslet Dr, Charlotte, NC 28277-2956 | 2017-07-25 |
| 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.