Carolinas Physicians Network, Inc

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

CAROLINAS PHYSICIANS NETWORK, INC

Practice address

1023 Edgehill Rd S
Charlotte, NC 28207-1829

Phone

(704) 355-8686

Fax

(704) 355-8687

NPI assigned

Jul 8, 2006

Organization subpart

Yes

Parent organization

CAROLINAS PHYSICIANS NETWORK INCAs reported in NPPES

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, Operations

Phone

(704) 355-0648

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• McKay Urology Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Part of

Cotswold Urgent Care

Locations

Practitioners 3

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

• Amber Leigh Herr, PA

  • Physician Assistant
  • Charlotte, NC
  • NPI 1740217058
  NPD
• Kelly R Moran, NP

  • Nurse Practitioner
  • Charlotte, NC
  • NPI 1114955242
  NPD
• Stephen F Shaban, MD

  • Urology Physician
  • Raleigh, NC
  • NPI 1780624411
  NPD (past)

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239580800000",
    "number": "1386677979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60628",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600628",
            "telephone_number": "704-355-8686",
            "fax_number": "704-355-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 EDGEHILL RD S",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071829",
            "telephone_number": "704-355-8686",
            "fax_number": "704-355-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS PHYSICIANS NETWORK, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS PHYSICIANS NETWORK INC",
        "enumeration_date": "2006-07-08",
        "last_updated": "2009-04-13",
        "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, OPERATIONS",
        "authorized_official_telephone_number": "704-355-0648"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPB184",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NBP184",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5904752",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McKay Urology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carolinas Physicians Network Inc.
• Carolinas Physicians Network Inc.
• Carolinas Physicians Network Inc.
• Carolinas Physicians Network Inc.
• Carolinas Physicians Network Inc.
• Carolinas Physicians Network, Inc
• Carolinas Physicians Network, Inc.
• Carolinas Physicians Network, Inc.
• Carolinas Physicians Network, Inc.
• Carolinas Physicians Network, Inc.

• Urology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Urology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; 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.