Organization Active NPI

Kent Seitz MD PA

  • General Practice Physician
  • Charlotte, NC
National Provider Identifier
1013210517
Registry record updated Sep 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
KENT SEITZ MD PA
Practice address
1421 Orchard Lake Drive
Suite C
Charlotte, NC 28270-9998
Phone
(704) 844-0181
Fax
(904) 701-6279
NPI assigned
Dec 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kent Seitz, M.D.NPI 1467469320
Title
Owner/President
Phone
(704) 844-0181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1421 Orchard Lake Drive
Suite C
Charlotte, NC 28270-9998

Mailing address

1421 Orchard Lake Drive
Suite C
Charlotte, NC 28270-9998
Phone (704) 844-0181

Other identifiers 1

IdentifierTypeStateIssuer
5914829MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110509000211 NC Part B Supplier - Clinic/Group Practice 8224214218 Receives reassigned benefits from 2 practitioners
Practice locations: Charlotte, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2019071Kent Seitz, MD PA1421 Orchard Lake, Suite C, Charlotte, NC 28270AccreditationJul 28, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441929600000",
    "number": "1013210517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 ORCHARD LAKE DRIVE",
            "address_2": "SUITE C",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282709998",
            "telephone_number": "704-844-0181",
            "fax_number": "904-701-6279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 ORCHARD LAKE DRIVE",
            "address_2": "SUITE C",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282709998",
            "telephone_number": "704-844-0181",
            "fax_number": "904-701-6279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT SEITZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-06",
        "last_updated": "2015-09-11",
        "status": "A",
        "authorized_official_last_name": "SEITZ",
        "authorized_official_first_name": "KENT",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "704-844-0181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5914829",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.