Individual provider Active NPI

Paul Jefferson Satterwhite Jr., RN

  • Registered Nurse
  • Charlotte, NC
National Provider Identifier
1184461832
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
366982 Issued in NC
Practice address
10926 David Taylor Dr Ste 120
Charlotte, NC 28262-0039
Phone
(864) 248-3882
NPI assigned
Jul 10, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 366982 NC Primary

Addresses

Primary practice location

10926 David Taylor Dr Ste 120
Charlotte, NC 28262-0039

Mailing address

5220 Ennisworth LN
Charlotte, NC 28214-4148
Phone (864) 248-3882

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
366982NCMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1184461832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 ENNISWORTH LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282144148",
            "telephone_number": "864-248-3882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10926 DAVID TAYLOR DR STE 120",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282620039",
            "telephone_number": "864-248-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SATTERWHITE",
        "first_name": "PAUL",
        "middle_name": "JEFFERSON",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "366982",
            "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 Jul 10, 2024; 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.