NPIMap

Organization Active NPI

Mecklenburg Open Door, Inc.

  • Adult Mental Health Clinic/Center
  • Charlotte, NC
National Provider Identifier
1407989874
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
MHL-060-993 Issued in NC
Legal business name
MECKLENBURG OPEN DOOR, INC.
Practice address
1211 Robinhood Cir
Charlotte, NC 28227-4036
Phone
(704) 563-8894
Fax
(704) 563-8619
NPI assigned
Mar 14, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Edward G Payton
Title
Executive Director
Phone
(704) 525-3255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X MHL-060-993 NC Primary

Addresses

Primary practice location

1211 Robinhood Cir
Charlotte, NC 28227-4036

Mailing address

1515 Mockingbird LN
Suite 1015
Charlotte, NC 28209-3236
Phone (704) 525-3255

Other identifiers 1

IdentifierTypeStateIssuer
7805619MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Mecklenburg Open Door Inc17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407989874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 MOCKINGBIRD LN",
            "address_2": "SUITE 1015",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093236",
            "telephone_number": "704-525-3255",
            "fax_number": "704-525-0949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 ROBINHOOD CIR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282274036",
            "telephone_number": "704-563-8894",
            "fax_number": "704-563-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECKLENBURG OPEN DOOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAYTON",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-525-3255",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NC",
            "license": "MHL-060-993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805619",
            "state": "NC"
        }
    ],
    "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 Aug 22, 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.