NPIMap

Organization Active NPI

Mecklenburg Open Door, Inc.

  • Adult Mental Health Clinic/Center
  • Charlotte, NC
National Provider Identifier
1285767665
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
MHL-060-454 Issued in NC
Legal business name
MECKLENBURG OPEN DOOR, INC.
Practice address
1518 Briar Creek Rd
Charlotte, NC 28205-5576
Phone
(704) 537-4544
Fax
(704) 537-4430
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Edward G Payton
Title
Executive Director
Phone
(704) 525-3255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X MHL-060-454 NC Primary

Addresses

Primary practice location

1518 Briar Creek Rd
Charlotte, NC 28205-5576

Mailing address

1515 Mockingbird LN
Sutie 1015
Charlotte, NC 28209-3236
Phone (704) 525-3255

Other identifiers 1

IdentifierTypeStateIssuer
7803476MedicaidNC

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": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285767665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 MOCKINGBIRD LN",
            "address_2": "SUTIE 1015",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093236",
            "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": "1518 BRIAR CREEK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282055576",
            "telephone_number": "704-537-4544",
            "fax_number": "704-537-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECKLENBURG OPEN DOOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "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_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NC",
            "license": "MHL-060-454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7803476",
            "state": "NC"
        }
    ],
    "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 Aug 22, 2020; 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.