Organization Active NPI

Charlotte Medical Clinic Inc

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1386947828
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CHARLOTTE MEDICAL CLINIC INC
Practice address
10650 Park Rd
Ste 300
Charlotte, NC 28210-8538
Phone
(704) 667-3960
NPI assigned
Dec 6, 2010
Organization subpart
Yes
Parent organization
CHARLOTTE MEDICAL CLINIC INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Authorized official

Name
Thomas Laymon
Title
Senior Vice President
Phone
(704) 446-8250

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X

Addresses

Primary practice location

10650 Park Rd
Ste 300
Charlotte, NC 28210-8538

Mailing address

PO Box 19305
Charlotte, NC 28219-9305
Phone (704) 631-0002

Other names 1

  • Charlotte Medical Clinic Doing business as

National Provider Directory

National Provider Directory
Part of
Charlotte Medical Clinic Inc

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583107200000",
    "number": "1386947828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305",
            "telephone_number": "704-631-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10650 PARK RD",
            "address_2": "STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108538",
            "telephone_number": "704-667-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE MEDICAL CLINIC INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHARLOTTE MEDICAL CLINIC INC",
        "enumeration_date": "2010-12-06",
        "last_updated": "2020-03-02",
        "status": "A",
        "authorized_official_last_name": "LAYMON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "704-446-8250"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charlotte Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Charlotte Medical Clinic",
            "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 Mar 2, 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.