Organization Active NPI

Medical Associates of Rock Hill

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1407185465
Registry record updated Mar 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDICAL ASSOCIATES OF ROCK HILL
Practice address
13640 Steelecroft Pkwy
Suite 220
Charlotte, NC 28278-7565
Phone
(803) 328-0181
Fax
(803) 328-0553
NPI assigned
Dec 21, 2009
Last updated
Mar 22, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2010

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 of Operations
Phone
(704) 355-0648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

13640 Steelecroft Pkwy
Suite 220
Charlotte, NC 28278-7565

Mailing address

PO Box 601586
Charlotte, NC 28260-1586
Phone (803) 328-0181

Other identifiers 1

IdentifierTypeStateIssuer
NPB359MedicaidSC

National Provider Directory

National Provider Directory

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": "1261353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269216000000",
    "number": "1407185465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601586",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601586",
            "telephone_number": "803-328-0181",
            "fax_number": "803-328-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13640 STEELECROFT PKWY",
            "address_2": "SUITE 220",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282787565",
            "telephone_number": "803-328-0181",
            "fax_number": "803-328-0553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF ROCK HILL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-21",
        "last_updated": "2010-03-22",
        "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 OF OPERATIONS",
        "authorized_official_telephone_number": "704-355-0648"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPB359",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 22, 2010; 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.