NPIMap

Individual provider Active NPI

Caroline Bock Reinke, FNP-C

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1205827326
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
181370 Issued in NC
Practice address
1001 Blythe Blvd
Suite 500
Charlotte, NC 28203-5866
Phone
(704) 355-5100
Fax
(704) 355-5180
NPI assigned
Oct 31, 2005
Last updated
Oct 14, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201679 NC
Family Nurse Practitioner 363LF0000X 181370 NC Primary

Addresses

Primary practice location

1001 Blythe Blvd
Suite 500
Charlotte, NC 28203-5866

Mailing address

PO Box 601643
Charlotte, NC 28260-1643
Phone (704) 355-5100

Other identifiers 3

IdentifierTypeStateIssuer
1205827326MedicaidNC
7003682MedicaidNC
7003874MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040807000216 NC Practitioner - Nurse Practitioner 8123090404 Reassigns benefits to 1 organization
I20200615002641 SC Practitioner - Nurse Practitioner 8123090404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Michigan Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians UnityGroup PAC ID 6406014919, 61 clinicians

Practice addresses (Care Compare)

10648 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-8050

1330 Taylor St
Columbia, SC 29201-2915
Phone (803) 296-5010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
181370NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Unity Family CurrentSince Apr 12, 2019 Accepting new patients
Mercy Health Services, Inc. Past Accepting new patients

Locations

10648 Park Rd
Charlotte, NC 28210
Phone (704) 355-9330

1330 Taylor St
Columbia, SC 29201
Phone (803) 296-5137

1333 Taylor St
Ste 4E
Columbia, SC 29201
Phone (803) 296-3956

5224 75th St
Ste D
Lubbock, TX 79424
Phone (806) 791-0042

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1205827326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601643",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601643",
            "telephone_number": "704-355-5100",
            "fax_number": "704-355-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BLYTHE BLVD",
            "address_2": "SUITE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035866",
            "telephone_number": "704-355-5100",
            "fax_number": "704-355-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINKE",
        "first_name": "CAROLINE",
        "middle_name": "BOCK",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "201679",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "181370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205827326",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7003682",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7003874",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.