ERICKSON HEALTH MEDICAL GROUP OF NORTH CAROLINA, PC (NPI# 1396241030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396241030 |
| Entity Type | Organization |
| Organization Name | ERICKSON HEALTH MEDICAL GROUP OF NORTH CAROLINA, PC |
| Practice Address |
2030 Windsor Run Lane Matthews NC 28105 |
| Mailing Address |
5525 Research Park Dr Fl 4 Baltimore MD 21228-4873 |
| Practice Telephone | 4104022258 |
| Practice Fax Number | 4102047279 |
| Mailing Telephone | 4104022258 |
| Mailing Fax Number | 4102047279 |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2019-07-18 |
| Authorized Official Name | MATTHEW J NARRETT (CHIEF MEDICAL OFFICER) |
| Authorized Official Telephone | 4104022220 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
2030 WINDSOR RUN LANE |
| City | MATTHEWS |
| State | NC |
| Zip Code | 28105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750917407 | Lauren Deasy Blackshaw | Counselor | 1163 Sam Newell Rd, Matthews, NC 28105 | 2020-03-13 |
| 1912549643 | Monarch | Community/Behavioral Health | 10545 Paces Avenue 634, Matthews, NC 28105 | 2019-10-15 |
| 1326515768 | Holly Harvey Heddleson | Nurse Practitioner | 1450 Matthews Township Pkwy Ste 280, Matthews, NC 28105 | 2018-10-24 |
| 1811406994 | Lice Clinics of America of The Carolinas | Technician, Other | 3042 Suite C Senna Dr, Matthews, NC 28105 | 2017-09-21 |
| 1376065003 | Carillon Assisted Living of Mint Hill, LLC | Custodial Care Facility | 5601 Margaret Wallace Road, Matthews, NC 28105 | 2017-07-14 |
| 1568906055 | London Young | Physical Therapy Assistant | 11100- 11189 Berkley Square Ln, Charlotte, NC 28105 | 2016-12-19 |
| 1003363128 | New Beginnings Community Counseling Center | Community/Behavioral Health | 5232 Maragaret Wallace Road, Matthews, NC 28105 | 2016-09-07 |
| 1275993149 | Kristi Dougan | Nurse Practitioner | 434 N Trade St Ste 104, Matthews, NC 28105 | 2016-03-04 |
| 1205219896 | Kalyani Vellanki Starr | Dentist | 1819 Matthews Township Pkwy Ste 200, Matthews, NC 28105 | 2015-07-01 |
| 1013395300 | South Charlotte Family Counseling | Counselor | 1214 Brightmoor Drive, Matthews, NC 28105 | 2015-05-07 |
| Find all providers in zip 28105 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| 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 |
|---|---|---|---|---|
| 1710480066 | Novant Medical Group, Inc. | Internal Medicine | 1450 Matthews Township Pkwy Ste 400, Matthews, NC 28105-5336 | 2018-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205324449 | Innovative Healthcare Management Provider Group | Internal Medicine | 19401 Old Jetton Rd Ste 100, Cornelius, NC 28031-6575 | 2018-04-24 |
| 1710306204 | Serena Wong | Internal Medicine | 40 Duke Medicine Cir Rm 2512, Durham, NC 27710-2527 | 2014-04-10 |
| 1033554811 | Ben Adam Blomberg | Internal Medicine | 6011 Farrington Rd, Suite 101, Chapel Hill, NC 27517-8168 | 2013-05-07 |
| 1881941706 | Robert Sullivan | Internal Medicine | 294 Highview Dr, Chapel Hill, NC 27517-7911 | 2012-08-09 |
| 1780974584 | Claire Kathryn Larson | Internal Medicine | 5003 Old Clinic Bldg Cb 7550, Chapel Hill, NC 27599-2204 | 2011-04-13 |
| 1316236649 | Mia Yang | Internal Medicine | Internal Medicine Section On Gerontology &, 1st Floor Sticht Center, Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2011-04-07 |
| 1659673838 | Moses Cone Affiliated Physicians, Inc. | Internal Medicine | 1200 N Elm Street, Moses Cone Health System, Administrativeservices,ste201, Greensboro, NC 27401-1020 | 2010-11-22 |
| 1871821728 | Pamela Estelle Gutman | Internal Medicine | 189 Country Club Rd, Asheville, NC 28804 | 2009-12-03 |
| 1861675613 | Nichole Marie Arkfeld | Internal Medicine | 3506 West Tyvola Road, Charlotte, NC 28208 | 2007-12-14 |
| 1881877959 | Gericare, PC | Internal Medicine | 409 North Estes Drive, Chapel Hill, NC 27514 | 2007-12-12 |
| Find all providers with the same taxonomy | ||||
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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.