NPIMap

Organization Active NPI

Carolinas Physicians Network Inc

Doing business as Union Medical Associates

  • Internal Medicine Physician
  • Monroe, NC
National Provider Identifier
1063767960
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CAROLINAS PHYSICIANS NETWORK INC
Doing business as
Union Medical Associates
Practice address
1303 Dove St
Monroe, NC 28112-5012
Phone
(704) 282-0488
Fax
(704) 282-4083
NPI assigned
Jul 17, 2012
Last updated
Apr 10, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
CAROLINAS PHYSICIANS NETWORK INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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

Authorized official

Name
Daniel L Wiens
Title
Administrator
Phone
(704) 355-0648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

1303 Dove St
Monroe, NC 28112-5012

Mailing address

PO Box 601888
Charlotte, NC 28260-1888
Phone (704) 282-0488

Other identifiers 2

IdentifierTypeStateIssuer
5908003MedicaidNC
NPB283MedicaidSC

Other names 1

  • Union Medical Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040115000819 NC Part B Supplier - Clinic/Group Practice 3375449655 Receives reassigned benefits from 2,518 practitioners
This NPI is an additional NPI on the enrollment
O20070329000229 NC Part B Supplier - Ambulatory Surgical Center 3375449655 Receives reassigned benefits from 3 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Charlotte, NC

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Carolinas Physicians Network Inc

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365552000000",
    "number": "1063767960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601888",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601888",
            "telephone_number": "704-282-0488",
            "fax_number": "704-282-4083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 DOVE ST",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281125012",
            "telephone_number": "704-282-0488",
            "fax_number": "704-282-4083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS PHYSICIANS NETWORK INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS PHYSICIANS NETWORK INC",
        "enumeration_date": "2012-07-17",
        "last_updated": "2013-04-10",
        "status": "A",
        "authorized_official_last_name": "WIENS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-355-0648"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908003",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPB283",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Union Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monroe, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.