NPIMap

Individual provider Active NPI

Fakhra Chaudhry, MD

  • Diagnostic Radiology Physician
  • Charlotte, NC
National Provider Identifier
1235357500
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2009-00095 Issued in NC
Practice address
3623 Latrobe Dr Ste 216
Charlotte, NC 28211
Phone
(704) 332-1291
Fax
(704) 332-5206
NPI assigned
Apr 23, 2007
Last updated
Sep 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2009-00095 NC Primary

Addresses

Primary practice location

3623 Latrobe Dr Ste 216
Charlotte, NC 28211

Mailing address

PO Box 221249
Charlotte, NC 28222-1249
Phone (704) 332-1291

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NJ2 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
I20090811000704 NC Practitioner - Diagnostic Radiology 7214081108 Reassigns benefits to 1 organization
I20240415000484 NJ Practitioner - Diagnostic Radiology 7214081108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Rutgers New Jersey Medical School, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progressive Physician Assoc IncGroup PAC ID 1355243809, 164 clinicians

Practice addresses (Care Compare)

10601 Flennigan Way
Charlotte, NC 28277-1416
Phone (401) 595-3073

110 Lake Rd
Basking Ridge, NJ 07920-1838
Phone (800) 475-6112

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Imaging Centers LLC Diagnostic Radiology CurrentSince Oct 1, 2022 Accepting new patients
Progressive Physician Assoc Inc Diagnostic Radiology CurrentSince Apr 1, 2022 Accepting new patients

Locations

185 Roseberry St
Phillipsburg, NJ 08865
Phone (908) 213-6611

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

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 10

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

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1235357500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 221249",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282221249",
            "telephone_number": "704-332-1291",
            "fax_number": "704-332-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3623 LATROBE DR STE 216",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28211",
            "telephone_number": "704-332-1291",
            "fax_number": "704-332-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAUDHRY",
        "first_name": "FAKHRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2009-00095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.