Charlotte Medical Clinic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CHARLOTTE MEDICAL CLINIC

Practice address

1001 Blythe Blvd
MCP Suite 500
Charlotte, NC 28203-5874

Phone

(704) 355-5100

Fax

(704) 355-5180

NPI assigned

Jul 12, 2006

Organization subpart

No

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

Authorized official

Name

Daniel L Wiens

Title

Senior Vice President

Phone

(704) 355-0648

Specialties & licenses 8

Addresses

Other identifiers 1

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Carolinas Physicians Network Inc

  dba Carolinas Integrative Health

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Charlotte, NC
  • NPI 1396886099

  Member Of

  NPD member
• The Charlotte-Mecklenburg Hospital Authority

  dba LHS Orthopaedics

  • Orthopaedic Surgery Physician
  • Denver, NC
  • NPI 1477884302

  Member Of

  NPD member

Locations

Practitioners 8

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

• Catherine Blair, NP-C

  • Nurse Practitioner
  • Wilmington, NC
  • NPI 1497181762
  NPD (past)
• Sheetal Desai-Oghra, MD

  • Hospitalist Physician
  • Charlotte, NC
  • NPI 1881864312

  Internal Medicine

  NPD (past)
• Cyndi Hoffman, FNP

  • Nurse Practitioner
  • Charlotte, NC
  • NPI 1548233786
  NPD (past)
• Kirk A. James, MD

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1235438870
  NPD (past)
• Tracy Sloan Lachell, NP

  • Nurse Practitioner
  • Charlotte, NC
  • NPI 1972267821
  NPD (past)
• Chelsea McCaskill, FNP

  • Family Nurse Practitioner
  • Charlotte, NC
  • NPI 1912334970
  NPD (past)
• Ravin Jayant Mehta, PA

  • Physician Assistant
  • Charlotte, NC
  • NPI 1356676548
  NPD (past)
• Lourdes Delacaridad Ovide, NP

  • Nurse Practitioner
  • Charlotte, NC
  • NPI 1780125484
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1083649214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601643",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601643",
            "telephone_number": "704-355-5100",
            "fax_number": "704-342-4354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BLYTHE BLVD",
            "address_2": "MCP SUITE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035874",
            "telephone_number": "704-355-5100",
            "fax_number": "704-355-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "WIENS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "704-355-0648"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89012Y0",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charlotte Mecklenburg Hospital Authority (Levine Cancer Institute)
• Charlotte Mecklenburg Hospital Authority (CMC Rx Morrocroft)
• Charlotte Medical Center
• Charlotte Medical Center
• Charlotte Medical Center PLLC
• Charlotte Medical Clinic
• Charlotte Medical Clinic
• Charlotte Medical Clinic Inc (Atrium Health Primary Care Charlotte Medical Clinic)
• Charlotte Medical Clinic Inc (Atrium Health Primary Care Charlotte Medical Clinic)
• Charlotte Medical Clinic Inc (Charlotte Medical Clinic)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.