NPIMap

Organization Active NPI

David C Matthews MD PA

  • Plastic Surgery Physician
  • Charlotte, NC
National Provider Identifier
1104959584
Registry record updated Mar 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
DAVID C MATTHEWS MD PA
Practice address
1719 South Blvd
Ste B
Charlotte, NC 28203-4727
Phone
(704) 375-2955
Fax
(704) 377-2766
NPI assigned
Mar 14, 2007
Last updated
Mar 11, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2009

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

Authorized official

Name
David C Matthews, M.D.NPI 1124091889
Title
Owner
Phone
(704) 375-2955

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
Plastic Surgery Physician 208200000X NU Primary

Addresses

Primary practice location

1719 South Blvd
Ste B
Charlotte, NC 28203-4727

Mailing address

1719 South Blvd
Ste B
Charlotte, NC 28203-4727
Phone (704) 375-2955

Other identifiers 2

IdentifierTypeStateIssuer
54819OtherNCBCBS OF NC
8954819MedicaidNC

National Provider Directory

National Provider Directory

Locations

1719 South Blvd
#B
Charlotte, NC 28203
Phone (704) 375-2955

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12631/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

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": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236729600000",
    "number": "1104959584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 SOUTH BLVD",
            "address_2": "STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282034727",
            "telephone_number": "704-375-2955",
            "fax_number": "704-377-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 SOUTH BLVD",
            "address_2": "STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282034727",
            "telephone_number": "704-375-2955",
            "fax_number": "704-377-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID C MATTHEWS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2009-03-11",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-375-2955",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "54819",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8954819",
            "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 Mar 11, 2009; 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.