Individual provider Active NPI

Mary Autumn Schultz

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1134475213
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
237142 Issued in NC
Practice address
13845 Conlan Cir
Charlotte, NC 28277-2705
Phone
(704) 544-2092
NPI assigned
Jul 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 237142 NC Primary

Addresses

Primary practice location

13845 Conlan Cir
Charlotte, NC 28277-2705

Mailing address

14106 Caraway Woods CT
Charlotte, NC 28277-3305
Phone (901) 413-7388

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

State licenses

LicenseStateTypeSpecialty
237142NCMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1343260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1134475213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14106 CARAWAY WOODS CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773305",
            "telephone_number": "901-413-7388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13845 CONLAN CIR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282772705",
            "telephone_number": "704-544-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "MARY",
        "middle_name": "AUTUMN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-26",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "237142",
            "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 Jun 12, 2013; 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.