Carolina Urology Center, PA

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

CAROLINA UROLOGY CENTER, PA

Practice address

10620 Park Rd
Suite 218
Charlotte, NC 28210-8472

Phone

(704) 543-7186

Fax

(704) 543-7094

NPI assigned

Jul 13, 2006

Last updated

Oct 9, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tracy Black

Title

Practice Manager

Phone

(803) 327-1116

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1114942927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1780 MEDICAL PARK DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321194",
            "telephone_number": "803-327-1116",
            "fax_number": "803-327-6872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10620 PARK RD",
            "address_2": "SUITE 218",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108472",
            "telephone_number": "704-543-7186",
            "fax_number": "704-543-7094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA UROLOGY CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "803-327-1116"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0127V",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890127V",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "02555",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolina Therapy Center LLC
• Carolina Therapy Specialists, PLLC
• Carolina Transport Alliance, Inc.
• Carolina Treatment & Family Services, Inc
• Carolina Upper Cervical Clinic, Inc.
• Carolina Vision Rehabilitation OD PLLC
• Carolina Women's Restorative Center, LLC
• Carolina Youth Association
• Carolina's Cancer Care 2LLC
• Carolina's Creative Counseling

• Urology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Urology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.