NPIMap

Organization Active NPI

First Care Medical Clinic

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1285759605
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
FIRST CARE MEDICAL CLINIC
Doing business as
First Care Medical Clinic
Practice address
9040 Nations Ford Rd
Charlotte, NC 28273-5716
Phone
(704) 291-9267
NPI assigned
Mar 21, 2007
Last updated
Sep 6, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

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

Authorized official

Name
Benedict O Okwara, MDNPI 1487613840
Title
Medical Director
Phone
(704) 225-8548

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X Primary
Pediatrics Physician 208000000X
Pediatric Adolescent Medicine Physician 2080A0000X
Podiatrist 213E00000X
Foot & Ankle Surgery Podiatrist 213ES0103X

Addresses

Primary practice location

9040 Nations Ford Rd
Charlotte, NC 28273-5716

Mailing address

404 S Sutherland Ave
Monroe, NC 28112-5060
Phone (704) 291-9267

Other identifiers 3

IdentifierTypeStateIssuer
2326436OtherNCMEDICARE GROUP #
89015HXMedicaidNC
015HXOtherNCBCBSNC

Other names 1

  • FIRST CARE MEDICAL CLINIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031208000408 NC Part B Supplier - Clinic/Group Practice 5395641823 Receives reassigned benefits from 46 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Monroe, NC; Gastonia, NC; Charlotte, NC; Albemarle, NC

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AEDABD

Practitioners & affiliated clinicians

Practitioners 7

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": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346889600000",
    "number": "1285759605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 S SUTHERLAND AVE",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281125060",
            "telephone_number": "704-291-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 NATIONS FORD RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282735716",
            "telephone_number": "704-291-9267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CARE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2012-09-06",
        "status": "A",
        "authorized_official_last_name": "OKWARA",
        "authorized_official_first_name": "BENEDICT",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "704-225-8548",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "2326436",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89015HX",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "015HX",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FIRST CARE MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.