NPIMap

Organization Active NPI

Mysupport

  • Peer Specialist
  • Charlotte, NC
National Provider Identifier
1073205837
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Legal business name
MYSUPPORT
Practice address
1100 Elliott Rd
Charlotte, NC 28216-1317
Phone
(252) 339-0864
NPI assigned
May 22, 2023
Last updated
May 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Authorized official

Name
Mr. Patrick Brian Irvine Jr., CPSSNPI 1780596023
Title
Ceo
Phone
(252) 339-0864

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

1100 Elliott Rd
Charlotte, NC 28216-1317

Mailing address

4509 Fair Springs Rd
Charlotte, NC 28227-5941
Phone (252) 339-0864

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1684713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684713600000",
    "number": "1073205837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4509 FAIR SPRINGS RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282275941",
            "telephone_number": "252-339-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 ELLIOTT RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282161317",
            "telephone_number": "252-339-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYSUPPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "IRVINE",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "252-339-0864",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "CPSS"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.