Individual provider Active NPI

Phuong Mai

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1508384934
Registry record updated Sep 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5009815 Issued in NC
Practice address
9915 Park Cedar Dr
Charlotte, NC 28210-8905
Phone
(866) 389-2727
Fax
(866) 389-2727
NPI assigned
Sep 6, 2017
Last updated
Sep 11, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5009815 NC Primary

Addresses

Primary practice location

9915 Park Cedar Dr
Charlotte, NC 28210-8905

Mailing address

2924 Alpine Forest CT
Charlotte, NC 28270
Phone (916) 873-7724

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171122002645 NC Practitioner - Nurse Practitioner 4486911666 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Onespotmd Primary and Urgent Care PLLCGroup PAC ID 4183036650, shared by 2 NPIs, 4 clinicians

Practice addresses (Care Compare)

2017 Central Ave
Suite 103
Charlotte, NC 28205-5388
Phone (704) 904-2133

2114 Freeman Park Dr
Suite 105
Charlotte, NC 28273-3238
Phone (704) 731-8656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5009815NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Onespotmd Primary and Urgent Care PLLC CurrentSince Jan 1, 2023 Accepting new patients
Onespotmd Primary and Urgent Care PLLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

2114 Freeman Park Dr
Ste 105
Charlotte, NC 28273
Phone (704) 731-8656

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505088000000",
    "number": "1508384934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2924 ALPINE FOREST CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28270",
            "telephone_number": "916-873-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9915 PARK CEDAR DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108905",
            "telephone_number": "866-389-2727",
            "fax_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAI",
        "first_name": "PHUONG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-06",
        "last_updated": "2017-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5009815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.