MECKLENBURG MEDICAL GROUP (NPI# 1396061347) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396061347 |
| Entity Type | Organization |
| Organization Name | MECKLENBURG MEDICAL GROUP |
| Other Organization Name | MECKLENBURG MEDICAL GROUP (MMG) |
| Practice Address |
7666 Charlotte Hwy Ste 200 Indian Land SC 29707-7000 |
| Mailing Address |
Po Box 19305 Charlotte NC 28219-9305 |
| Practice Telephone | 7043029600 |
| Mailing Telephone | 7046310002 |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2020-08-31 |
| Authorized Official Name | THOMAS LAYMON (SENIOR VICE PRESIDENT) |
| Authorized Official Telephone | 7044468250 |
| Is Organization Subpart | Y |
| Parent Organization Name | MECKLENBURG MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RB0002X |
Internal Medicine Specialization: Obesity Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| N | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Mecklenburg Medical Group (MMG) | Doing Business As Name - Organization |
| Mecklenburg Medical Group (MMG) | Other Name - Individual/Organization |
| 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 |
7666 CHARLOTTE HWY STE 200 |
| City | INDIAN LAND |
| State | SC |
| Zip Code | 29707-7000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356332779 | Joyce Ward | Family Medicine | 7666 Charlotte Hwy, Suite 120, Indian Land, SC 29707-7000 | 2005-11-03 |
| 1437543139 | Ada Wilson | Nurse Practitioner | 7666 Charlotte Hwy, Suite 120, Indian Land, SC 29707-7000 | 2015-03-20 |
| 1750795183 | Patrick Jenkins IIi | Family Medicine | 7666 Charlotte Hwy, Suite 120, Indian Land, SC 29707-7000 | 2014-06-13 |
| 1669808234 | Amanda Langford | Nurse Practitioner | 7666 Charlotte Hwy, Suite 120, Indian Land, SC 29707-7000 | 2013-09-16 |
| 1477991479 | Seth Vining | Internal Medicine | 7666 Charlotte Hwy, Ste 200, Indian Land, SC 29707-7000 | 2013-06-12 |
| 1669738829 | The Charlotte-mecklenburg Hospital Authority | Internal Medicine | 7666 Charlotte Hwy, Suite 200-a, Indian Land, SC 29707-7000 | 2012-04-02 |
| 1104113745 | Charlotte Cardiology Associates, Pllc | Internal Medicine | 7666 Charlotte Hwy, Ste 230, Indian Land, SC 29707 | 2011-07-04 |
| 1720378136 | Matthew Thomas | Family Medicine | 7666 Charlotte Hwy, Suite 120, Indian Land, SC 29707-7000 | 2011-04-19 |
| 1386963221 | Erin Marcotsis | Internal Medicine | 7666 Charlotte Hwy, Suite 120, Indian Land, SC 29707-7000 | 2010-05-17 |
| 1649595067 | Carolinas Physicians Network Inc | Internal Medicine | 7666 Charlotte Hwy, Suite 250, Indian Land, SC 29707-7000 | 2010-03-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535844 | Anomaly Bodywork & Wellness Center, LLC | Massage Therapist | 4068 Flats Main Street, Apt 100, Indian Land, SC 29707 | 2020-10-15 |
| 1164034369 | Renu Kapoor Virdi | Dentist | 9709 Redstone Dr, Ste 500, Indian Land, SC 29707 | 2020-08-19 |
| 1205467420 | Brian Keith Sutton | Physical Therapist | 2021 Bridgemill Dr, Ste 106, Indian Land, SC 29707 | 2020-01-27 |
| 1215575774 | Doby's Bridge Dentistry | Dentist | 4174 Dobys Brige Road Ste 100, Indian Land, SC 29707 | 2019-12-16 |
| 1346895141 | Redstone Modern Dentistry, PC | Dentist | 9709 Redstone Dr., Suite 500, Indian Land, SC 29707 | 2019-08-08 |
| 1396228698 | Daniel Allen | Massage Therapist | 4068 Flats Main St, Apt 100, Indian Land, SC 29707 | 2018-09-12 |
| 1598269409 | Dawn K Beatty-batten | Occupational Therapy Assistant | The Blake At Edgewater, 1099 Edgewater Corporate Parkway, Indian Land, SC 29707 | 2018-03-23 |
| 1366940959 | Kds Consultants, LLC | Family Medicine | 8351 Charlotte Hwy Ste 200, Indian Land, SC 29707 | 2018-01-29 |
| 1093227464 | Ivision Associates LLC | Optometrist | 9700 Red Stone Drive Suite 300, Indian Land, SC 29707 | 2017-10-25 |
| 1396274742 | Carson Tyler Mcginn | Specialist/Technologist | 8690 Henry Harris Rd., Fort Mill, SC 29707 | 2017-06-08 |
| Find all providers in zip 29707 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366075343 | Dermatology and Skin Surgery Inc | Dermatology | 325 Broad St Ste 200, Sumter, SC 29150-4167 | 2020-02-18 |
| 1942844667 | Oakview Dermatology | Dermatology | 937 Riverwalk Pkwy Ste 202, Rock Hill, SC 29730-0178 | 2019-11-06 |
| 1427614577 | Georgia Dermatology & Skin Cancer Center, LLC | Dermatology | 2110 Woodside Executive Court, Aiken, SC 29803-3809 | 2019-05-14 |
| 1578038535 | Integrated Dermatology of Hilton Head, LLC | Dermatology | 3901 Main St Ste D, Hilton Head, SC 29926-4613 | 2018-10-05 |
| 1982138715 | Skin Solution To Massage | Dermatology | 1 Chick Springs Rd Ste 207a, Greenville, SC 29609-4976 | 2017-04-19 |
| 1700272978 | Leah Swanson | Dermatology | 135 Rutledge Ave # Msc578, Charleston, SC 29425-8903 | 2015-04-14 |
| 1730596685 | Atlantic Dermatology | Dermatology | 3600 Sea Mountain Hwy Ste A, Little River, SC 29566-8161 | 2014-07-11 |
| 1598179947 | Georgetown Physician Associates, LLC | Dermatology | 4033 Highway 17, Suite 105, Murrells Inlet, SC 29576-5032 | 2014-06-13 |
| 1770996621 | David Mark Perry | Dermatology | 48 Folly Road Blvd, Charleston, SC 29407-7507 | 2014-06-09 |
| 1891106811 | Sarah M. Derrington | Dermatology | 9217 University Blvd., Ste C1b, Charleston, SC 29406 | 2014-05-13 |
| Find all providers with the same taxonomy | ||||
| City | INDIAN LAND |
| Zip Code | 29707 |
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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.