Active NPI
Sudipta Mazumder, MD
- Internal Medicine Physician
- Charlotte, NC
National Provider Identifier
1467560805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 2006-01321
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006-01321 | NC | MD | Hospitalist 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.