Glencora Kheireddine, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2009-00399 Issued in NC

Practice address

6060 Piedmont Row Dr S FL 7
Charlotte, NC 28287

Phone

(704) 489-3094

NPI assigned

Mar 5, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1295864379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5950 FAIRVIEW RD STE 330",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282102108",
            "telephone_number": "704-495-6334",
            "fax_number": "704-817-7219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6060 PIEDMONT ROW DR S FL 7",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28287",
            "telephone_number": "704-489-3094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4525 Cameron Valley Pkwy",
            "address_2": "Suite 3100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282114369",
            "country_code": "US",
            "telephone_number": "704-302-9300",
            "fax_number": "704-302-9305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHEIREDDINE",
        "first_name": "GLENCORA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "134019",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2009-00399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N0039D",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5913167",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Payal Khanna, FNP, PMHNP
• Khans Family, Inc.
• Rod Khansari, DMD
• Rozie Anna Khashmanian, LCSW
• Haseeb Mohammad Khatri, MD
• Vanesh Khetpal, MD
• Sanjay J Khiani, MD
• Alec Khlebopros, D.C.
• Khmorgan Holdings LLC Dba Griswold Home Care for West Charlotte
• Jing Yi Khoo, 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 Sep 27, 2018; 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.