Individual provider Active NPI

Sudipta Mazumder, MD

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1467560805
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2006-01321 Issued in NC
Practice address
7108 Pineville Matthews Rd Ste 102
Charlotte, NC 28226-8380
Phone
(704) 542-2191
NPI assigned
Aug 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 2006-01321 NC
Internal Medicine Physician 207R00000X 2006-01321 NC Primary

Addresses

Primary practice location

7108 Pineville Matthews Rd Ste 102
Charlotte, NC 28226-8380

Mailing address

7108 Pineville Matthews Rd Ste 102
Charlotte, NC 28226-8380
Phone (704) 542-2191

Other practice location 1

1000 Blythe Blvd
CMC Annex 1st Floor
Charlotte, NC 28203-5812
Phone (704) 355-0720

Other practice location 2

10628 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-7070

Other practice location 3

487 Lake Concord Rd NE
Concord, NC 28025-2934
Phone (704) 403-0100

Other practice location 4

10648 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-7070

Other practice location 5

1100 Blythe Blvd
Charlotte, NC 28203-5814
Phone (704) 355-4475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2006-01321NCMDHospitalist Physician

NPI Registry JSON

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1467560805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7108 PINEVILLE MATTHEWS RD STE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282268380",
            "telephone_number": "704-542-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7108 PINEVILLE MATTHEWS RD STE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282268380",
            "telephone_number": "704-542-2191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Blythe Blvd",
            "address_2": "CMC Annex 1st Floor",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035812",
            "country_code": "US",
            "telephone_number": "704-355-0720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10628 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108407",
            "country_code": "US",
            "telephone_number": "704-667-7070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "487 Lake Concord Rd NE",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252934",
            "country_code": "US",
            "telephone_number": "704-403-0100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10648 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108407",
            "country_code": "US",
            "telephone_number": "704-667-7070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Blythe Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035814",
            "country_code": "US",
            "telephone_number": "704-355-4475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZUMDER",
        "first_name": "SUDIPTA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-27",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2006-01321",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2006-01321",
            "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 Oct 30, 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.