Organization Active NPI

Northwest Family Physicians, P.a.

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1093721722
Registry record updated Jan 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTHWEST FAMILY PHYSICIANS, P.A.
Practice address
7920 Moores Chapel Rd
Charlotte, NC 28214-9453
Phone
(704) 926-7800
Fax
(704) 926-7806
NPI assigned
Aug 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2010

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

Authorized official

Name
Mr. William G. Larsen, M.D.NPI 1164483004
Title
Owner
Phone
(704) 926-7800

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

7920 Moores Chapel Rd
Charlotte, NC 28214-9453

Mailing address

7920 Moores Chapel Rd
Charlotte, NC 28214-9453
Phone (704) 926-7800

Other identifiers 1

IdentifierTypeStateIssuer
89-011A0MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040614001291 NC Part B Supplier - Clinic/Group Practice 9436133972 Receives reassigned benefits from 6 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
34D0948982Northwest Family Physicians PA7920 Moores Chapel Rd, Charlotte, NC 28214Provider-performed microscopyMar 13, 2028

National Provider Directory

National Provider Directory

Locations

7920 Moores Chapel Rd
Charlotte, NC 28214
Phone (704) 926-7800

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": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263168000000",
    "number": "1093721722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7920 MOORES CHAPEL RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282149453",
            "telephone_number": "704-926-7800",
            "fax_number": "704-926-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7920 MOORES CHAPEL RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282149453",
            "telephone_number": "704-926-7800",
            "fax_number": "704-926-7806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST FAMILY PHYSICIANS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2010-01-11",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-926-7800",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89-011A0",
            "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 Jan 11, 2010; 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.