Organization Active NPI

Carefirst Medical Associates, PC

  • Clinic/Center
  • Charlotte, NC
National Provider Identifier
1447636790
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
2009-00568 Issued in NC
Legal business name
CAREFIRST MEDICAL ASSOCIATES, PC
Practice address
2908 Oak Lake Blvd
Suite 205
Charlotte, NC 28208-7703
Phone
(704) 567-8233
NPI assigned
Aug 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Authorized official

Name
Dr. Johnnie Lyles, M.D., M.B.A.NPI 1841491370
Title
Cmo
Phone
(704) 496-9032

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 2009-00568 NC Primary

Addresses

Primary practice location

2908 Oak Lake Blvd
Suite 205
Charlotte, NC 28208-7703

Mailing address

2908 Oak Lake Blvd
Suite 205
Charlotte, NC 28208-7703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160229002415 NC Part B Supplier - Clinic/Group Practice 7113222175 Receives reassigned benefits from 1 practitioner
Practice locations: Charlotte, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2104044Carefirst Medical Associates, PLLC2908 Oak Lake Boulevard, Suite 205, Charlotte, NC 28208Certificate of waiverMar 13, 2028

National Provider Directory

National Provider Directory

Locations

2908 Oak Lake Blvd
Ste 205
Charlotte, NC 28208
Phone (704) 496-9032

Practitioners & affiliated clinicians

Practitioners 1

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": "1439078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1447636790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2908 OAK LAKE BLVD",
            "address_2": "SUITE 205",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282087703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2908 OAK LAKE BLVD",
            "address_2": "SUITE 205",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282087703",
            "telephone_number": "704-567-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAREFIRST MEDICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "LYLES",
        "authorized_official_first_name": "JOHNNIE",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "704-496-9032",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., M.B.A."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NC",
            "license": "2009-00568",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.