Relymd Medical Group NC, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

RELYMD MEDICAL GROUP NC, PLLC

Doing business as

RelyMD Medical Group

Practice address

212 S Tryon St Ste 1000
Charlotte, NC 28281-0001

Phone

(919) 932-0928

NPI assigned

Aug 21, 2020

Organization subpart

Yes

Parent organization

RELYMD MEDICAL GROUP, LLCAs reported in NPPES

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

Authorized official

Name

Ronald Michael Creatore

Title

Cfo/General Counsel

Phone

(919) 932-0928

Specialties & licenses 1

Addresses

Other names 1

• RelyMD Medical Group Doing business as

Part of

Relymd Medical Group LLC

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

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598400000000",
    "number": "1083226906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 MEADOWMONT VILLAGE CIR STE 323",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275177584",
            "telephone_number": "919-932-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S TRYON ST STE 1000",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282810001",
            "telephone_number": "919-932-0928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELYMD MEDICAL GROUP NC, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RELYMD MEDICAL GROUP, LLC",
        "enumeration_date": "2020-08-21",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A",
        "authorized_official_last_name": "CREATORE",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO/GENERAL COUNSEL",
        "authorized_official_telephone_number": "919-932-0928"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RelyMD Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RelyMD Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.