United Primary Diagnostic Center

Primary specialty

Community Health Nurse PractitionerTaxonomy code 363LC1500X

Legal business name

UNITED PRIMARY DIAGNOSTIC CENTER

Practice address

2103 N Graham St Ste B
Charlotte, NC 28206-2548

Phone

(336) 370-9232

Fax

(336) 274-7200

NPI assigned

Apr 10, 2019

Last updated

Dec 17, 2020By 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

Enasha L James

Title

Medical Administrator

Phone

(980) 237-4768

Specialties & licenses 7

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608163200000",
    "number": "1316400088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 N GRAHAM ST STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282062548",
            "telephone_number": "336-370-9232",
            "fax_number": "336-274-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 N GRAHAM ST STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282062548",
            "telephone_number": "336-370-9232",
            "fax_number": "336-274-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "721 Spruce St",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282034330",
            "country_code": "US",
            "telephone_number": "704-258-2580",
            "fax_number": "336-274-7200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1207 4th St.",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274056622",
            "country_code": "US",
            "telephone_number": "336-370-9232 x117",
            "fax_number": "336-274-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "UNITED PRIMARY DIAGNOSTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-10",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "ENASHA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEDICAL ADMINISTRATOR",
        "authorized_official_telephone_number": "980-237-4768"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "unitedprimarydiagnosticcenter@gmail.com",
            "affiliation": "N",
            "endpointDescription": "unitedprimarydiagnosticcenter@gmail.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2103 N Graham St Ste B",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282062548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Community Health Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Community Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.