Active NPI
William Richard Lorenz Jr.
- Surgery Physician
- Charlotte, NC
National Provider Identifier
1194301564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 302741
- Practice address
- 1000 Blythe Blvd Ste 601
Charlotte, NC 28203-5812 - Phone
- (704) 355-7874
- NPI assigned
- Mar 24, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 302741 | NC | |
| Surgery Physician | 208600000X | 302741 | NC | Primary |
Addresses
Primary practice location
1000 Blythe Blvd Ste 601
Charlotte, NC 28203-5812
Mailing address
1000 Blythe Blvd Ste 601
Charlotte, NC 28203-5812
Phone (704) 355-7874
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 302741 | NC | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616889600000",
"number": "1194301564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 BLYTHE BLVD STE 601",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035812",
"telephone_number": "704-355-7874",
"fax_number": "704-355-5619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 BLYTHE BLVD STE 601",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035812",
"telephone_number": "704-355-7874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LORENZ",
"first_name": "WILLIAM",
"middle_name": "RICHARD",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-24",
"last_updated": "2021-03-28",
"certification_date": "2021-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NC",
"license": "302741",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NC",
"license": "302741",
"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 Mar 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.