Active NPI
J. Octavio Salazar, MD
- Psychiatry Physician
- Charlotte, NC
National Provider Identifier
1477601896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD063774L
- Practice address
- 6412 Cedar Croft Dr
Charlotte, NC 28270-0300 - Phone
- (704) 733-9913
- NPI assigned
- Jan 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD063774L | PA | Primary |
Addresses
Primary practice location
6412 Cedar Croft Dr
Charlotte, NC 28270-0300
Mailing address
6412 Cedar Croft Dr
Charlotte, NC 28270-0300
Phone (704) 733-9913
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FOR KMH 5905907 | Medicaid | NC | |
| FOR CMCR 5905907 | Medicaid | NC |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD063774L | PA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243900800000",
"number": "1477601896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6412 CEDAR CROFT DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282700300",
"telephone_number": "704-733-9913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6412 CEDAR CROFT DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282700300",
"telephone_number": "704-733-9913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALAZAR",
"first_name": "J. OCTAVIO",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2009-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD063774L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "FOR KMH 5905907",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "FOR CMCR 5905907",
"state": "NC"
}
],
"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 Jun 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.