DR. BRADLEY KENT WEISNER (NPI# 1619910627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619910627 |
| Entity Type | Individual |
| Full Name | DR. BRADLEY KENT WEISNER |
| Credential | M.D. |
| Practice Address |
1450 Matthews Township Pkwy Suite 350 Matthews NC 28105-2387 |
| Mailing Address |
Po Box 36488 Charlotte NC 28236-6488 |
| Practice Telephone | 7048418877 |
| Practice Fax Number | 7048418188 |
| Mailing Telephone | 7042483400 |
| Mailing Fax Number | 7043378387 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2008-05-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 9400668 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | RAILROAD MCRE PROV# | 340016171 | 01 |
| NC | PARTNERS PROVIDER# | 23482 | 01 |
| NC | BCBS NC INDI PROV# | 86336 | 01 |
| Street Address |
1450 MATTHEWS TOWNSHIP PKWY SUITE 350 |
| City | MATTHEWS |
| State | NC |
| Zip Code | 28105-2387 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649273673 | Todd M Kopczynski | Obstetrics & Gynecology | 1450 Matthews Township Pkwy, Suite 300, Matthews, NC 28105-2387 | 2005-05-23 |
| 1508393927 | Novant Medical Group, Inc. | Surgery | 1450 Matthews Township Pkwy, Suite 320, Matthews, NC 28105-2387 | 2017-05-16 |
| 1932631850 | Novant Medical Group, Inc. | Surgery | 1450 Matthews Township Pkwy, Suite 355, Matthews, NC 28105-2387 | 2017-03-30 |
| 1033566526 | Novant Medical Group, Inc. | Obstetrics & Gynecology | 1450 Matthews Township Pkwy, Suite 410, Matthews, NC 28105-2387 | 2016-05-16 |
| 1134506348 | Novant Health Matthews Medical Center | General Acute Care Hospital | 1450 Matthews Township Pkwy, Suite 150, Matthews, NC 28105-2387 | 2015-04-27 |
| 1053705418 | Suzanne Lake | Speech-Language Pathologist | 1450 Matthews Township Pkwy, Suite 150, Matthews, NC 28105-2387 | 2015-03-24 |
| 1386032647 | Leah Miles Alexander | Physician Assistant | 1450 Matthews Township Pkwy, Suite 250, Matthews, NC 28105-2387 | 2015-01-08 |
| 1225426976 | Novant Health Matthews Medical Center | General Acute Care Hospital | 1450 Matthews Township Pkwy, Suite 150, Matthews, NC 28105-2387 | 2015-01-05 |
| 1063753325 | Novant Medical Group Inc | Obstetrics & Gynecology | 1450 Matthews Township Pkwy, Suite 300, Matthews, NC 28105-2387 | 2013-03-12 |
| 1487906590 | Presbyterian Medical Care Corp | Emergency Medicine | 1450 Matthews Township Pkwy, Suite 170, Matthews, NC 28105-2387 | 2012-10-12 |
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| 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 |
| 1396241030 | Erickson Health Medical Group of North Carolina, PC | Internal Medicine | 2030 Windsor Run Lane, Matthews, NC 28105 | 2018-04-02 |
| 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 |
| Find all providers in zip 28105 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780021600 | Roger Jo-chieh Yau | Urology | 1450 Matthews Township Pkwy Ste 350, Matthews, NC 28105-2388 | 2013-06-01 |
| 1699095331 | Novant Medical Group, Inc. | Urology | 1401 Matthews Township Pkwy, Suite 312, Matthews, NC 28105-5402 | 2010-06-04 |
| 1497978837 | Samuel Stuart Dupuy Jr. | Urology | 1450 Matthews Township Parkway, Matthews, NC 28105 | 2007-04-11 |
| 1801839378 | Thomas Hogeman Phillips | Urology | 1450 Matthews Township Pkwy, Suite 350, Matthews, NC 28105-2387 | 2006-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528673423 | Meredith Abernethy | Urology | 140 Kimel Park Dr # 100, Winston Salem, NC 27103-6184 | 2020-09-09 |
| 1942833678 | Joshua Daniel Howell | Urology | 10650 Park Rd Ste 320, Charlotte, NC 28210-8543 | 2020-02-21 |
| 1144887019 | Shuo Liu | Urology | Department of Urology Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2019-05-25 |
| 1427563725 | Hifu Prostate Services, LLC | Urology | 4108 Park Rd Ste 205, Charlotte, NC 28209-2260 | 2017-12-08 |
| 1134644859 | Ilan Binyamin Klein | Urology | Wake Forest Baptist Health, Department of Urology, Medical Center Boulevard, Winston-salem, NC 27157 | 2017-08-03 |
| 1184163883 | Dlp Central Carolina Medical Group LLC | Urology | 1139 Carthage St Ste 110-b, Sanford, NC 27330-4111 | 2017-02-15 |
| 1578007225 | Cumberland County Hospital System Inc | Urology | 805 Tilghman Dr, Suite A, Dunn, NC 28334-5887 | 2016-12-15 |
| 1063963080 | Novant Medical Group, Inc | Urology | 1730 Kernersville Medical Pkwy Ste 303, Kernersville, NC 27284-7198 | 2016-10-14 |
| 1588019152 | Murphy Medical Center, Inc. | Urology | 75 Medical Park Ln Ste A, Murphy, NC 28906-6673 | 2016-05-02 |
| 1427446723 | Regional Physicians LLC | Urology | 217- 218 Gatewood Ave, High Point, NC 27262-4877 | 2015-01-08 |
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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.