Active NPI
Worley Shaun Lynch, PA
- Medical Physician Assistant
- Charlotte, NC
National Provider Identifier
1114299294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 0010-03368
- Practice address
- 1900 Randolph Rd
Suite 900
Charlotte, NC 28207-1122 - Phone
- (704) 377-2424
- Fax
- (704) 377-2687
- NPI assigned
- Feb 3, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 0010-03368 | NC | Primary |
Addresses
Primary practice location
1900 Randolph Rd
Suite 900
Charlotte, NC 28207-1122
Mailing address
1900 Randolph Rd
Suite 900
Charlotte, NC 28207-1122
Phone (704) 377-2424
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-03368 | NC | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328227200000",
"number": "1114299294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 RANDOLPH RD",
"address_2": "SUITE 900",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282071122",
"telephone_number": "704-377-2424",
"fax_number": "704-377-2687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 RANDOLPH RD",
"address_2": "SUITE 900",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282071122",
"telephone_number": "704-377-2424",
"fax_number": "704-377-2687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYNCH",
"first_name": "WORLEY",
"middle_name": "SHAUN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-03",
"last_updated": "2012-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NC",
"license": "0010-03368",
"primary": true
}
],
"identifiers": [],
"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 Feb 3, 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.