NPIMap

Organization Active NPI

Mecklenburg County

  • Public Health or Welfare Agency
  • Charlotte, NC
National Provider Identifier
1396814331
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
MECKLENBURG COUNTY
Practice address
3205 Freedom Dr Ste 7500
Charlotte, NC 28208-3490
Phone
(704) 336-7100
NPI assigned
Nov 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Authorized official

Name
Raynard E Washington, PHD
Title
Health Director
Phone
(980) 579-0671

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

3205 Freedom Dr Ste 7500
Charlotte, NC 28208-3490

Mailing address

700 E 4TH St
Charlotte, NC 28202-2886
Phone (980) 314-8640

Other identifiers 2

IdentifierTypeStateIssuer
1396814331MedicaidNC
3403416MedicaidNC

Other names 2

  • MECKLENBURG COUNTY CHILDRENS DEVELOPMENTAL SERVICES AGENCY Doing business as
  • Mecklenburg County Children's Developmental Services Agency Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL HIE

National Provider Directory

National Provider Directory
Tax ID family
Mecklenburg County32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

Locations

3205 Freedom Dr
Ste 7500
Charlotte, NC 28208
Phone (704) 336-7130

3500 Ellington St
#G
Charlotte, NC 28211

700 E 4th St
Charlotte, NC 28202
Phone (704) 336-8100

Practitioners & affiliated clinicians

Practitioners 2

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": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643673600000",
    "number": "1396814331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E 4TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022886",
            "telephone_number": "980-314-8640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 FREEDOM DR STE 7500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282083490",
            "telephone_number": "704-336-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECKLENBURG COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "RAYNARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "980-579-0671",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396814331",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3403416",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "HIE",
            "affiliation": "N",
            "address_1": "3205 Freedom Dr Ste 7500",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282083490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MECKLENBURG COUNTY CHILDRENS DEVELOPMENTAL SERVICES AGENCY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mecklenburg County Children's Developmental Services Agency",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Mecklenburg County Children's Developmental Services Agency",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Feb 1, 2022; 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.