NPIMap

Organization Active NPI

Mecklenburg Open Door/Charlottetown Clinic

  • Community/Behavioral Health Agency
  • Charlotte, NC
National Provider Identifier
1225279490
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MECKLENBURG OPEN DOOR/CHARLOTTETOWN CLINIC
Practice address
3501 E Independence Blvd
Charlotte, NC 28205-7261
Phone
(704) 525-3255
Fax
(704) 525-0949
NPI assigned
Mar 17, 2009
Last updated
Mar 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

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

Authorized official

Name
Edward G Payton, MHA
Title
Executive Director
Phone
(704) 525-3255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

3501 E Independence Blvd
Charlotte, NC 28205-7261

Mailing address

1515 Mockingbird Lane
Suite 1015
Charlotte, NC 28209-3294
Phone (704) 525-3255

National Provider Directory

National Provider Directory
Tax ID family
Mecklenburg Open Door Inc17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1225279490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 MOCKINGBIRD LANE",
            "address_2": "SUITE 1015",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093294",
            "telephone_number": "704-525-3255",
            "fax_number": "704-525-0949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 E INDEPENDENCE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282057261",
            "telephone_number": "704-525-3255",
            "fax_number": "704-525-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECKLENBURG OPEN DOOR/CHARLOTTETOWN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-17",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "PAYTON",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-525-3255",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "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 17, 2009; 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.