CAROLINAS PHYSICIANS NETWORK INC (NPI# 1699085605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699085605 |
| Entity Type | Organization |
| Organization Name | CAROLINAS PHYSICIANS NETWORK INC |
| Other Organization Name | SENIOR HEALTH CONNECTION |
| Practice Address |
332 Sam Newell Rd Suite 2000 Matthews NC 28105-6566 |
| Mailing Address |
Po Box 602148 Charlotte NC 28260-2148 |
| Practice Telephone | 7043028375 |
| Practice Fax Number | 7043028548 |
| Mailing Telephone | 7043028375 |
| Mailing Fax Number | 7043028548 |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2013-01-07 |
| Authorized Official Name | DANIEL WIENS (SENIOR VICE PRESIDENT) |
| Authorized Official Telephone | 7043550648 |
| Is Organization Subpart | Y |
| Parent Organization Name | CAROLINAS PHYSICIANS NETWORK INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Senior Health Connection | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619582343 | Carolinas Physicians Network Inc | Pediatrics | 9908 Couloak Dr Ste 103, Charlotte, NC 28216-8678 | 2020-09-10 |
| 1992310627 | Carolinas Physicians Network Inc | Pediatrics | 1585 Forney Creek Pkwy Ste 2100, Denver, NC 28037-9520 | 2020-09-10 |
| 1518571421 | Carolinas Physicians Network Inc | Pediatrics | 1154 Carolina Pl, Fort Mill, SC 29708-7063 | 2020-09-08 |
| 1568075422 | Carolinas Physicians Network Inc | Orthopaedic Surgery | 10660 Park Rd Ste 3100, Charlotte, NC 28210-8420 | 2020-08-28 |
| 1861004426 | Carolinas Physicians Network Inc | Pediatrics | 4501 Cameron Valley Pkwy Ste 200-b, Charlotte, NC 28211-4297 | 2020-08-17 |
| 1821613480 | Carolinas Physicians Network Inc | Internal Medicine | 8815 Christenbury Pkwy Ste 30, Concord, NC 28027-0261 | 2020-06-10 |
| 1932722980 | Carolinas Physicians Network Inc | Internal Medicine | 2041 South Blvd, Ste 100, Charlotte, NC 28203-5062 | 2020-05-26 |
| 1902429863 | Carolinas Physicians Network Inc | Orthopaedic Surgery | 2700 Providence Rd S Ste 225, Waxhaw, NC 28173-6314 | 2020-05-26 |
| 1184244881 | Carolinas Physicians Network Inc | Obstetrics & Gynecology | 150 Professional Park Dr Ste 200, Mooresville, NC 28117-5604 | 2020-04-22 |
| 1649890468 | Carolinas Physicians Network Inc | Family Medicine | 150 Professional Park Dr Ste 400, Mooresville, NC 28117-5604 | 2020-04-22 |
| Street Address |
332 SAM NEWELL RD SUITE 2000 |
| City | MATTHEWS |
| State | NC |
| Zip Code | 28105-6566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124096953 | Kevyn Miller | Physician Assistant | 332 Sam Newell Rd, Suite 1100, Matthews, NC 28105-6566 | 2006-03-09 |
| 1770859126 | Charlotte Mecklenburg Hospital Authority | Internal Medicine | 332 Sam Newell Rd, Suite 2000, Matthews, NC 28105-6566 | 2012-03-30 |
| 1346547809 | Carolinas Medical Center | Physical Medicine & Rehabilitation | 332 Sam Newell Rd, Suite 1200, Matthews, NC 28105-6566 | 2011-02-18 |
| 1710202163 | Mecklenburg Medical Group | Internal Medicine | 332 Sam Newell Rd, Suite 2000, Matthews, NC 28105-6566 | 2010-03-29 |
| 1194854778 | Catherine Janell Tewolde | Nurse Practitioner | 332 Sam Newell Rd, Matthews, NC 28105-6566 | 2007-03-02 |
| 1568561330 | Leigh Sullivan Clavin | Pharmacist | 332 Sam Newell Rd, Matthews, NC 28105 | 2006-09-21 |
| 1790709210 | John E. Davenport | Internal Medicine | 332 Sam Newell Rd, Suite 2000, Matthews, NC 28105-6566 | 2006-07-27 |
| 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 | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with 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 Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649765058 | Frances Elizabeth Sutton | Family Medicine | 180 Southwood Dr, Clinton, NC 28328-5002 | 2018-06-27 |
| 1023313855 | Triangle Geriatrics & Palliative Medicine, Pllc | Family Medicine | 1010 Rosehill Ave, Durham, NC 27705-4019 | 2011-01-26 |
| 1316259013 | Graceful Aging,pc | Family Medicine | 2732 Bardolino Dr, Fayetteville, NC 28306-4636 | 2010-07-09 |
| 1306092549 | Coastal Mobile Medical Doctor, Pa | Family Medicine | 203 Stagecoach Dr, Jacksonville, NC 28546-9617 | 2008-08-07 |
| 1457541484 | North River Primecare PC | Family Medicine | 301 Jones Ave, Beaufort, NC 28516-1514 | 2007-07-26 |
| 1790812840 | Geridoc LLC | Family Medicine | 4431 Montibello Dr, Charlotte, NC 28226-7420 | 2007-02-27 |
| 1174658371 | Brunswick Gericare PC | Family Medicine | 602 Thomasboro Road, Calabash, NC 28467-9820 | 2007-02-21 |
| 1952446080 | Jeffrey Dean Martin | Family Medicine | North Carolina Disability Determination Services, 3301 Terminal Dr, Raleigh, NC 27602-0243 | 2007-02-20 |
| 1912048273 | Shine Thomas | Family Medicine | 1601 Brennar Ave, Salisbury, NC 28144-2515 | 2007-02-09 |
| 1982766283 | Balaji Pabbu | Family Medicine | 101 Heart Drive, Mail Stop 654, Greenville, NC 27834 | 2006-12-14 |
| 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.