Mecklenburg Medical Group

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MECKLENBURG MEDICAL GROUP

Practice address

4525 Cameron Valley Pkwy
Suite 2100
Charlotte, NC 28211-4369

Phone

(704) 302-8350

Fax

(704) 302-8351

NPI assigned

Apr 19, 2010

Last updated

Aug 15, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Ford Laymon

Title

Senior Vice President

Phone

(704) 631-0002

Specialties & licenses 14

Addresses

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Carolinas Physicians Network Inc

  dba Charles Crumley MD

  • Internal Medicine Physician
  • Lincolnton, NC
  • NPI 1639108533

  Member Of

  NPD member
• The Charlotte-Mecklenburg Hospital Authority

  dba Levine Cancer Institute

  • Surgical Oncology Physician
  • Monroe, NC
  • NPI 1124393657

  Member Of

  NPD member

Locations

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rhonda Sue Ardelean, PA

  • Physician Assistant
  • Charlotte, NC
  • NPI 1174552020
  NPD
• Jordan Renee Baker, PA

  • Physician Assistant
  • Charlotte, NC
  • NPI 1013262393
  NPD
• Lindsey Bilger, PA

  • Physician Assistant
  • Charlotte, NC
  • NPI 1902139397
  NPD
• Amber Harden Brown, PA

  • Medical Physician Assistant
  • Shelby, NC
  • NPI 1801122304
  NPD
• Stephanie Hammes Brown, PA

  • Physician Assistant
  • Kings Mountain, NC
  • NPI 1477973154
  NPD
• Christina Marie Bullard, PA

  • Physician Assistant
  • Charlotte, NC
  • NPI 1578866075
  NPD
• Catherine Leigh Ellison, PA

  • Physician Assistant
  • Charlotte, NC
  • NPI 1174916068
  NPD
• Adrienne King Frentzel, PA

  • Physician Assistant
  • Concord, NC
  • NPI 1386948974
  NPD
• Anna Elizabeth Garris, PA

  • Physician Assistant
  • Lincolnton, NC
  • NPI 1730330077
  NPD
• Jane Renee Gunter, PA-C

  • Physician Assistant
  • Shelby, NC
  • NPI 1417121427
  NPD
• Jennifer L. Haugen, PA

  • Physician Assistant
  • Mint Hill, NC
  • NPI 1871500553
  NPD
• Michelle Simmons Hopkins, PA

  • Physician Assistant
  • Huntersville, NC
  • NPI 1699877340
  NPD

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

{
    "created_epoch": "1271635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471219200000",
    "number": "1477879260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601643",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601643",
            "telephone_number": "704-302-8350",
            "fax_number": "704-302-8351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 CAMERON VALLEY PKWY",
            "address_2": "SUITE 2100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114369",
            "telephone_number": "704-302-8350",
            "fax_number": "704-302-8351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECKLENBURG MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-19",
        "last_updated": "2016-08-15",
        "status": "A",
        "authorized_official_last_name": "LAYMON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "FORD",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "704-631-0002",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mecklenburg Medical Group
• Mecklenburg Medical Group
• Mecklenburg Medical Group (Atrium Health Primary Care Mecklenburg Medical Group)
• Mecklenburg Medical Group (Mecklenburg Medical Group (MMG))
• Mecklenburg Medical Group
• Mecklenburg Medical Group (Atrium Health Primary Care Mecklenburg Medical Group)
• Mecklenburg Medical Group
• Mecklenburg Medical Group (Mecklenburg Medical Group (MMG))
• Mecklenburg Medical Group
• Mecklenburg Medical Group

• Durable Medical Equipment & Medical Supplies in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Durable Medical Equipment & Medical Supplies in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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.