Organization Active NPI

Dynamic Health Complete Care PLLC

  • Psychiatry Physician
  • Charlotte, NC
National Provider Identifier
1205602067
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
DYNAMIC HEALTH COMPLETE CARE PLLC
Practice address
4705 South Blvd
2ND Floor
Charlotte, NC 28217
Phone
(980) 247-6288
NPI assigned
Dec 1, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Authorized official

Name
Dr. Thomas Fitzgerald, MD
Title
Medical Director
Phone
(704) 525-6288

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

4705 South Blvd
2ND Floor
Charlotte, NC 28217

Mailing address

4705 South Blvd
2ND Floor
Charlotte, NC 28217
Phone (980) 247-6288

Other names 1

  • DHCC Other name

National Provider Directory

National Provider Directory

Locations

4705 South Blvd
Fl 2
Charlotte, NC 28217
Phone (980) 247-6288

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1701388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701388800000",
    "number": "1205602067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 SOUTH BLVD",
            "address_2": "2ND FLOOR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28217",
            "telephone_number": "980-247-6288",
            "fax_number": "704-525-6384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 SOUTH BLVD",
            "address_2": "2ND FLOOR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28217",
            "telephone_number": "980-247-6288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC HEALTH COMPLETE CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-01",
        "last_updated": "2023-12-01",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "704-525-6288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DHCC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Dec 1, 2023; 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.