NPIMap

Individual provider Active NPI

Stephen B Clyne, M.D.

  • Otolaryngology Physician
  • Charlotte, NC
National Provider Identifier
1427026210
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
2002-01229 Issued in NC
Practice address
10512 Park Rd
Suite 200
Charlotte, NC 28210-8475
Phone
(704) 295-3000
Fax
(704) 838-8494
NPI assigned
Mar 9, 2006
Last updated
Apr 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 2002-01229 NC Primary

Addresses

Primary practice location

10512 Park Rd
Suite 200
Charlotte, NC 28210-8475

Mailing address

6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000

Other identifiers 11

IdentifierTypeStateIssuer
D3210OtherNCMEDCOST
N0122AMedicaidSC
20079900OtherSCSELECT HEALTH OF SC
772913OtherSCWELLCARE
3476629OtherNCAETNA HMO/EPO/SELECT
4823670OtherNCCIGNA
80401OtherSCCHCCARES OF SC
1377KOtherNCBCBS
2422065OtherNCUNITED HEALTHCARE
7368564OtherNCAETNA
891377MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sclyne5484@direct.ceenta.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040603000316 NC Practitioner - Otolaryngology 5496737447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10405 Centrum Pkwy
Pineville, NC 28134-8825
Phone (704) 295-3650

6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000

708 S S St
Suite 300
Mount Airy, NC 27030-4589
Phone (336) 786-7366

724 Aubrey Bell Dr
Matthews, NC 28105-5055
Phone (704) 295-3550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2002-01229NCMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Eye Ear Nose & Throat Associates, P.a. Otolaryngology CurrentSince Jul 15, 2004 Accepting new patients
Charlotte Eye Ear Nose & Throat Associates, PA CurrentSince Jul 15, 2004 Accepting new patients
Charlotte Eye Ear Nose & Throat Associates, PA Otolaryngology PastSince Apr 13, 2025 Accepting new patients

Locations

10512 Park Rd
Ste 200
Charlotte, NC 28210
Phone (704) 295-3650

5933 Blakeney Park Dr
Ste 200
Charlotte, NC 28277
Phone (704) 295-3311

6035 Fairview Rd
Charlotte, NC 28210
Phone (336) 718-2078

724 Aubrey Bell Dr
Ste 201
Matthews, NC 28105

10405 Centrum Pkwy
Pineville, NC 28134
Phone (704) 295-3650

Interoperability endpoints

  • Direct secure messaging: sclyne499837@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: sclyne5484@direct.ceenta.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1427026210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6035 FAIRVIEW RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103256",
            "telephone_number": "704-295-3000",
            "fax_number": "704-838-8494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10512 PARK RD",
            "address_2": "SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108475",
            "telephone_number": "704-295-3000",
            "fax_number": "704-838-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYNE",
        "first_name": "STEPHEN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "2002-01229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D3210",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N0122A",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH OF SC",
            "identifier": "20079900",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "772913",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO/EPO/SELECT",
            "identifier": "3476629",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4823670",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHCCARES OF SC",
            "identifier": "80401",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1377K",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2422065",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7368564",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891377",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sclyne5484@direct.ceenta.com",
            "affiliation": "N",
            "address_1": "10512 Park Rd",
            "address_2": "Suite 200",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282108475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.