DYNAMIC HEALTH AND PAIN MANAGEMENT, PLLC (NPI# 1538452982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538452982 |
| Entity Type | Organization |
| Organization Name | DYNAMIC HEALTH AND PAIN MANAGEMENT, PLLC |
| Practice Address |
4707 South Blvd Charlotte NC 28217-2117 |
| Practice Telephone | 7045256288 |
| Practice Fax Number | 7045256384 |
| Mailing Telephone | 7045256288 |
| Mailing Fax Number | 7045256384 |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2017-05-09 |
| Authorized Official Name | HEIDI COX (SECRETARY/TREASURER) |
| Authorized Official Telephone | 7045256288 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111NR0400X |
Chiropractor Specialization: Rehabilitation |
Chiropractic Providers | ||
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | 222692 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 208D00000X | General Practice | 9900407 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | MEDICARE DME PTAN | 6558080001 | 01 |
| Street Address |
4707 SOUTH BLVD |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28217-2117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043821218 | Premier Cardiovascular Care & Wellness | Internal Medicine | 4707 South Blvd, Charlotte, NC 28217-2117 | 2020-08-12 |
| 1780211342 | Chioma Blessing Ejiogu | Nurse Practitioner | 4707 South Blvd, Charlotte, NC 28217-2117 | 2020-03-24 |
| 1366097859 | Martha Barbu | Nurse Practitioner | 4707 South Blvd, Charlotte, NC 28217-2117 | 2019-08-02 |
| 1275198558 | Salomon Guillermo Pinargote Sanchez | Physician Assistant | 4707 South Blvd, Charlotte, NC 28217-2117 | 2019-05-02 |
| 1093287534 | Dynamichealth2you, Pllc | General Practice | 4707 South Blvd, Charlotte, NC 28217-2117 | 2018-12-21 |
| 1073047379 | Kani Smith | Nurse Practitioner | 4707 South Blvd, Charlotte, NC 28217-2117 | 2017-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962017798 | Kelby Rae Hurlocker | Specialist/Technologist | 500 Center Park Dr, Charlotte, NC 28217 | 2020-09-09 |
| 1356967749 | Optum Pharmacy 701, LLC | Pharmacy | 4015 Shopton Rd, Suite 600, Charlotte, NC 28217 | 2020-06-22 |
| 1598302937 | Brigit Boyce | Occupational Therapist | 8848 Red Oak Blvd, Ste Aa, Charlotte, NC 28217 | 2019-12-04 |
| 1275016933 | Zarah Pulfrey | Physician Assistant | Womack Medical Center, 2817 Riley Road, Fort Bragg, NC 28217 | 2018-09-10 |
| 1972085918 | Dynamic Health Medical Group Pllc | Pain Medicine | 4705 South Blvd, Charlotte, NC 28217 | 2018-09-06 |
| 1184102048 | Charday Caple | Counselor | 735 Echodale Dr, Charlotte, NC 28217 | 2018-08-02 |
| 1326532250 | Dupont Livery LLC | Non-emergency Medical Transport (VAN) | 4200 S Tryon St, Charlotte, NC 28217 | 2018-06-14 |
| 1891215232 | Lakesha Shamise Welch | Counselor | 5709 South Hampton R., Charlotte, NC 28217 | 2017-06-27 |
| 1245768282 | Allison Harris Lafone | Counselor | 515 Clanton Road, Charlotte, NC 28217 | 2017-06-02 |
| 1619416906 | Charlie Randolph Taylor Jr. | Counselor | 517 Clanton Road, Charlotte, NC 28217 | 2017-02-20 |
| Find all providers in zip 28217 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679184055 | Healthworks Med Group of North Carolina P C | General Practice | 2320 Cascade Pointe Blvd, Charlotte, NC 28208-7203 | 2020-08-11 |
| 1053953125 | Emergent Life Integrative Medicine Center, Inc | General Practice | 5104 Reagan Drive, Suite 4, Charlotte, NC 28206-1392 | 2019-10-10 |
| 1780189902 | Izadora Izidoro Diehl | General Practice | 5128 Silabert Ave, Charlotte, NC 28205-7863 | 2018-03-28 |
| 1851799696 | Hak Jin Kim | General Practice | 2095 Brunswick Place, Charlotte, MI 48813-9751 | 2014-12-10 |
| 1992055941 | Healthworks Med Group of North Carolina P C | General Practice | 2605 Water Ridge Pkwy, Suite 100, Charlotte, NC 28217-4565 | 2012-09-18 |
| 1811296494 | Rene Chike Anikwue | General Practice | 5109 Monroe Rd Ste E, Charlotte, NC 28205-7878 | 2011-03-21 |
| 1235433723 | David Joseph Pasek | General Practice | 9216 Forest Manor Ct, Charlotte, NC 28215-9705 | 2010-12-27 |
| 1053625574 | Chs North Carolina Medical, P.C. | General Practice | 7201 Hewitt Associates Dr, Ste 500, Charlotte, NC 28262-4001 | 2010-07-27 |
| 1255587903 | Stuart Lee Schnider | General Practice | 3220 Latrobe Dr, Charlotte, NC 28211-4845 | 2008-08-13 |
| 1235184813 | Health-pro Mental Health Services Pllc | General Practice | 6700 Fairview Rd, Suite 420, Charlotte, NC 28210-3324 | 2006-05-23 |
| Find all providers in CHARLOTTE | ||||
Please comment or provide details below to improve the information on DYNAMIC HEALTH AND PAIN MANAGEMENT, PLLC.
| 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.