Carolina Advanced Wellness, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CAROLINA ADVANCED WELLNESS, PLLC

Practice address

16623 Birkdale Commons Pkwy Ste 120
Huntersville, NC 28078-5641

Phone

(704) 247-8355

NPI assigned

Apr 20, 2021

Last updated

Apr 20, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jerry Allen SaundersNPI 1306137526

Title

Owner

Phone

(704) 316-5635

Specialties & licenses 1

Addresses

Tax ID family

Carolina Advanced Wellness PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Carolina Advanced Wellness, PLLC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1235710211
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jerry Allen Saunders, MD

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1306137526
  NPD (past) Authorized official

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618876800000",
    "number": "1417538497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11035 GOLF LINKS DR # 79217",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282778045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16623 BIRKDALE COMMONS PKWY STE 120",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785641",
            "telephone_number": "704-247-8355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA ADVANCED WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-20",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A",
        "authorized_official_last_name": "SAUNDERS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-316-5635"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carillon Assisted Living of Huntersville, LLC
• Ann Carter Carlson
• Mollie Carlson
• Paulina Carmona-Rodriguez, PA-C
• Jason Anthony Carnes, MD
• Carolina Advanced Wellness, PLLC
• Carolina Age Management Institute, PC
• Carolina Biooncology Institute, PLLC
• Carolina Counseling and Consulting Services, PLLC
• Carolina Ear, Nose & Throat Head and Neck Surgery Center, P.a.

• Internal Medicine Physician in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.