Mecklenburg Medical Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MECKLENBURG MEDICAL GROUP

Practice address

7903 Providence Rd
Suite 100
Charlotte, NC 28277-9720

Phone

(704) 367-8610

Fax

(704) 367-6798

NPI assigned

Jul 9, 2006

Last updated

Mar 6, 2013By 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

Daniel L Wiens

Title

Senior Vice President

Phone

(704) 355-0648

Specialties & licenses 9

Addresses

Other identifiers 12

Locations

Practitioners 14

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.

• Anne Elizabeth Barnard, MD

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1093733404
  NPD (past)
• Enrico Orlando Belgrave, MD

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1518982586
  NPD (past)
• Ashley Dunigan, PA

  • Physician Assistant
  • Charlotte, NC
  • NPI 1063431997
  NPD (past)
• Cynthia Eaton, NP

  • Nurse Practitioner
  • Charlotte, NC
  • NPI 1720029408
  NPD (past)
• John McNeil Gibson, M.D.

  • Internal Medicine Physician
  • Huntersville, NC
  • NPI 1740204478
  NPD (past)
• Sindhu Liz Joseph, MD

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1114103520
  NPD (past)
• Erica Lynn Mauney, PA

  • Physician Assistant
  • Charlotte, NC
  • NPI 1033849278
  NPD (past)
• Andrea Memmen McGrath, M. D.

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1790707784
  NPD (past)
• David Weldon Miller, M.D.

  • Hematology (Internal Medicine) Physician
  • Charlotte, NC
  • NPI 1679592430
  NPD (past)
• Rena Arlene O'Connor, PA-C

  • Physician Assistant
  • Charlotte, NC
  • NPI 1831970706
  NPD (past)
• Ma Cristina Mereria Ocampo, NC

  • Family Medicine Physician
  • Matthews, NC
  • NPI 1659357309
  NPD (past)
• Kristina Nicole Olang, FNP

  • Family Nurse Practitioner
  • Charlotte, NC
  • NPI 1316423957
  NPD (past)

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362528000000",
    "number": "1255364535",
    "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": "704-367-8610",
            "fax_number": "704-367-6798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7903 PROVIDENCE RD",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282779720",
            "telephone_number": "704-367-8610",
            "fax_number": "704-367-6798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECKLENBURG MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2013-03-06",
        "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": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89013CO",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89013CX",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89013CY",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E08621",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89013PP",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905557",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89015NA",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901377",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902311",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903117",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89013AF",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89013CW",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mecklenburg Health Care Center, Inc. (Mecklenburg Health & Rehabilitation Center)
• Mecklenburg Heart Specialists, P.a.
• Mecklenburg Home Health, Inc. (Home Health Professionals)
• Mecklenburg Medical Group
• Mecklenburg Medical Group
• Mecklenburg Medical Group
• Mecklenburg Medical Group
• Mecklenburg Medical Group (Atrium Health Primary Care Mecklenburg Medical Group)
• Mecklenburg Medical Group (Mecklenburg Medical Group (MMG))
• Mecklenburg Medical Group

• 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 Mar 6, 2013; 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.