Eagle Medical Center

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2005-01333 Issued in NC

Legal business name

EAGLE MEDICAL CENTER

Practice address

1951 Old Steele Creek Road
Charlotte, NC 28208-5631

Phone

(704) 926-5434

Fax

(704) 454-7388

NPI assigned

Sep 9, 2009

Last updated

Dec 12, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gbenga Aluko, MDNPI 1437102753

Title

Medical Director

Phone

(704) 975-6004

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Eagle Medical Center

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1487942314

  O20091211000566

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 4

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.

• Gbenga Aluko, MD

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1437102753
  Medicare reassignment Authorized official
• Kathleen Elise Barber, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Charlotte, NC
  • NPI 1770067399
  NPD (past)
• Michelle Victoria- Dominique Harvey, PA-C

  • Physician Assistant
  • Gastonia, NC
  • NPI 1962160549
  NPD (past)
• Kimberly J Green, D.O

  • General Practice Physician
  • Alpharetta, GA
  • NPI 1720174873
  NPD (past)

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260576000000",
    "number": "1245563352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 667889",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282667889",
            "telephone_number": "704-926-5434",
            "fax_number": "704-454-7388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 OLD STEELE CREEK ROAD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282085631",
            "telephone_number": "704-926-5434",
            "fax_number": "704-454-7388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-09",
        "last_updated": "2009-12-12",
        "status": "A",
        "authorized_official_last_name": "ALUKO",
        "authorized_official_first_name": "GBENGA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "704-975-6004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2005-01333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUSHIELD",
            "identifier": "14096",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902507",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278746",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Avery Eady
• Eagle Africa Trading and Distribution Corporation
• Eagle Africa Trading and Distribution Corporation
• Eagle Care ABA
• Eagle Chiropractic Clinic
• Eagle Medical Center
• Eagle Rising Health Services, PLLC
• Eagle Therapeutic Services PLLC
• Eagles Will NC LLC
• Kathryn Grace Eaker, MD

• Internal Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.