Active NPI
Pediatric Endocrinology & Diabetes Specialists
- Pediatric Endocrinology Physician
- Shelby, NC
National Provider Identifier
1356665756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Endocrinology Physician
- Legal business name
- PEDIATRIC ENDOCRINOLOGY & DIABETES SPECIALISTS
- Practice address
- 709 N Dekalb St
Shelby, NC 28150-3911 - Phone
- (704) 512-3636
- Fax
- (704) 334-7956
- NPI assigned
- Mar 15, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Daniel L Wiens
- Title
- Senior Vice President
- Phone
- (704) 355-0648
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Endocrinology Physician | 2080P0205X | Primary |
Addresses
Primary practice location
709 N Dekalb St
Shelby, NC 28150-3911
Mailing address
PO Box 601381
Charlotte, NC 28260-1381
Phone (704) 512-3636
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5902857 | Medicaid | NC |
National Provider Directory
National Provider DirectoryMember of 2
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Sanger Heart and Vascular Institute - Kings Mountain
- Cardiovascular Disease Physician
- Kings Mountain, NC
- NPI 1184066342
Member Of
-
dba Atrium Health Primary Care Cabarrus Family Medicine Midland
- Family Medicine Physician
- Midland, NC
- NPI 1265869846
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268611200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1333411200000",
"number": "1356665756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 601381",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282601381",
"telephone_number": "704-512-3636",
"fax_number": "704-334-7956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "709 N DEKALB ST",
"city": "SHELBY",
"state": "NC",
"postal_code": "281503911",
"telephone_number": "704-512-3636",
"fax_number": "704-334-7956"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEDIATRIC ENDOCRINOLOGY & DIABETES SPECIALISTS",
"organizational_subpart": "NO",
"enumeration_date": "2010-03-15",
"last_updated": "2012-04-03",
"status": "A",
"authorized_official_last_name": "WIENS",
"authorized_official_first_name": "DANIEL",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
"authorized_official_telephone_number": "704-355-0648"
},
"taxonomies": [
{
"code": "2080P0205X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics, Pediatric Endocrinology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5902857",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Shelby, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.