NPIMap

Organization Active NPI

North Charlotte Medical Specialists

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1205864352
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NORTH CHARLOTTE MEDICAL SPECIALISTS
Practice address
101 E WT Harris Blvd
Suite 5002
Charlotte, NC 28262-3485
Phone
(704) 548-8724
Fax
(704) 548-0927
NPI assigned
Jun 29, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Daniel L. Wiens
Title
Senior Vice President
Phone
(704) 355-0648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

101 E WT Harris Blvd
Suite 5002
Charlotte, NC 28262-3485

Mailing address

5000 Airport Center Pkwy Ste a
Charlotte, NC 28208-5899
Phone (704) 512-4116

Other identifiers 1

IdentifierTypeStateIssuer
89013AGMedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205864352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 AIRPORT CENTER PKWY STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282085899",
            "telephone_number": "704-512-4116",
            "fax_number": "704-548-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E WT HARRIS BLVD",
            "address_2": "SUITE 5002",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623485",
            "telephone_number": "704-548-8724",
            "fax_number": "704-548-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CHARLOTTE MEDICAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WIENS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "704-355-0648"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89013AG",
            "state": "NC"
        }
    ],
    "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 Aug 22, 2020; 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.