Active NPI
Eugene P Christian, MD
- Specialist
- Charlotte, NC
National Provider Identifier
1356313431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 01593
- Practice address
- 3541 Randolph Rd
Suite 201
Charlotte, NC 28211-1082 - Phone
- (704) 944-0143
- Fax
- (704) 944-7399
- NPI assigned
- Feb 3, 2006
- Last updated
- Oct 30, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 01593 | NC | Primary |
Addresses
Primary practice location
3541 Randolph Rd
Suite 201
Charlotte, NC 28211-1082
Mailing address
3541 Randolph Rd
Suite 201
Charlotte, NC 28211-1082
Phone (704) 944-0143
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 890238K | Other | NC | NC MEDICAID GROUP NUMBER |
| MEDCOST | Other | NC | MEDCOST ID # |
| 1401K | Other | NC | BCBS ID # |
| 561549396 | Other | NC | TAX ID # |
| 5903047 | Medicaid | NC | |
| 4227249 | Other | NC | AETNA ID # |
| 7268317 | Other | NC | CIGNA HEALTHCARE ID # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Granger Medical Specialists LLC | Past | Accepting new patients | |
| Granger Medical Clinic PC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Medical Specialty Clinic/Center
- Sandy, UT
- NPI 1871320028
-
- Clinic/Center
- West Valley City, UT
- NPI 1376159368
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225324800000",
"number": "1356313431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3541 RANDOLPH RD",
"address_2": "SUITE 201",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282111082",
"telephone_number": "704-944-0143",
"fax_number": "704-944-7399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3541 RANDOLPH RD",
"address_2": "SUITE 201",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282111082",
"telephone_number": "704-944-0143",
"fax_number": "704-944-7399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRISTIAN",
"first_name": "EUGENE",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-03",
"last_updated": "2008-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NC",
"license": "01593",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC MEDICAID GROUP NUMBER",
"identifier": "890238K",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST ID #",
"identifier": "MEDCOST",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS ID #",
"identifier": "1401K",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID #",
"identifier": "561549396",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5903047",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA ID #",
"identifier": "4227249",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHCARE ID #",
"identifier": "7268317",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
- Katie Nicole Christensen
- Wayne Nels Christensen, M.D.
- Christian Doula Fellowship, LLC
- Christian Focus Counseling Service
- Christian Women of Elegance, Inc. (Beatties Ford Family Counseling & Vocational Rehabilitation Center)
- Lakishia Lawon Christian, CHW
- Montoya M Christian
- Christine Walker Physical Therapy, LLC
- Ashley Britton Christmas, MD
- Michael Matthew Christo, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.