NPIMap

Organization Active NPI

Metrolina AIDS Project, Inc.

Doing business as Metrolina Care Network

  • Health Service Clinic/Center
  • Charlotte, NC
National Provider Identifier
1164675914
Registry record updated Jun 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
METROLINA AIDS PROJECT, INC.
Doing business as
Metrolina Care Network
Practice address
5801 Executive Center Dr
Suite 114
Charlotte, NC 28212-8861
Phone
(704) 936-4460
Fax
(704) 936-4470
NPI assigned
Oct 24, 2008
Last updated
Jun 15, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
METROLINA AIDS PROJECT, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 15, 2009

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

Authorized official

Name
Dr. Jose R Diaz, M.D.
Title
Executive Director
Phone
(704) 333-1435

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X NU Primary

Addresses

Primary practice location

5801 Executive Center Dr
Suite 114
Charlotte, NC 28212-8861

Mailing address

PO Box 32662
Charlotte, NC 28232-2662
Phone (704) 333-1435

Other identifiers 1

IdentifierTypeStateIssuer
2335882OtherMEDICARE PTAN

Other names 1

  • Metrolina Care Network Doing business as

National Provider Directory

National Provider Directory
Part of
Metrolina AIDS Project

Locations

5801 Executive Center Dr
Ste 104
Charlotte, NC 28212
Phone (704) 936-4460

5801 Executive Center Dr
Ste 114
Charlotte, NC 28212
Phone (704) 936-4460

Practitioners & affiliated clinicians

Practitioners 6

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": "1224806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245024000000",
    "number": "1164675914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32662",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282322662",
            "telephone_number": "704-333-1435",
            "fax_number": "704-602-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 EXECUTIVE CENTER DR",
            "address_2": "SUITE 114",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128861",
            "telephone_number": "704-936-4460",
            "fax_number": "704-936-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROLINA AIDS PROJECT, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METROLINA AIDS PROJECT, INC.",
        "enumeration_date": "2008-10-24",
        "last_updated": "2009-06-15",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-333-1435",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2335882",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metrolina Care Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 15, 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.