Lake Norman Endocrinology & Diabetes, PC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

9400602 Issued in NC

Legal business name

LAKE NORMAN ENDOCRINOLOGY & DIABETES, PC

Practice address

143 Joe Knox Ave
Suite 100
Mooresville, NC 28117-9243

Phone

(704) 664-2936

NPI assigned

Aug 3, 2011

Organization subpart

No

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

Authorized official

Name

Augustine U Obi, M.D.

Title

Owner

Phone

(704) 664-2910

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348617600000",
    "number": "1114205457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 JOE KNOX AVE",
            "address_2": "SUITE 100",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179243",
            "telephone_number": "704-664-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 JOE KNOX AVE",
            "address_2": "SUITE 100",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179243",
            "telephone_number": "704-664-2936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE NORMAN ENDOCRINOLOGY & DIABETES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-03",
        "last_updated": "2012-09-26",
        "status": "A",
        "authorized_official_last_name": "OBI",
        "authorized_official_first_name": "AUGUSTINE",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-664-2910",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NC",
            "license": "9400602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5918299",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Lake Norman Emergency Medical Associates LLC
• Lake Norman Eye OD PA
• Lake Norman Hematology and Oncology Specialists PA
• Lake Norman Hematology Oncology Specialists, PA
• Lake Norman Inpatient Specialists
• Lake Norman Integrative Psychiatry

• Endocrinology, Diabetes & Metabolism Physician in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Endocrinology, Diabetes & Metabolism Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; 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.