Organization Active NPI

Mercy Medical Clinic PA

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1316627771
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MERCY MEDICAL CLINIC PA
Practice address
9510 University City Blvd Ste 102
Charlotte, NC 28213-3997
Phone
(704) 833-8037
Fax
(704) 691-0415
NPI assigned
Jul 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Authorized official

Name
Dr. Olusola Joseph, DNP, FNP-CNPI 1922470723
Title
Provider
Phone
(704) 833-8037

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

9510 University City Blvd Ste 102
Charlotte, NC 28213-3997

Mailing address

9510 University City Blvd Ste 102
Charlotte, NC 28213-3997
Phone (704) 833-8037

Other names 1

  • MERCY MEDICAL CLINIC PA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240603001713 NC Part B Supplier - Clinic/Group Practice 3577005834 Receives reassigned benefits from 1 practitioner
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Locations

9510 University City Blvd
Ste 102
Charlotte, NC 28213
Phone (704) 833-8037

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1689811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787875200000",
    "number": "1316627771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9510 UNIVERSITY CITY BLVD STE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282133997",
            "telephone_number": "704-833-8037",
            "fax_number": "704-691-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9510 UNIVERSITY CITY BLVD STE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282133997",
            "telephone_number": "704-833-8037",
            "fax_number": "704-691-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MEDICAL CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-20",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "OLUSOLA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "704-833-8037",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, FNP-C"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MERCY MEDICAL CLINIC PA",
            "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 Aug 28, 2026; 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.