Carolina Physicians Group, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0099-01172 Issued in NC

Legal business name

CAROLINA PHYSICIANS GROUP, PC

Practice address

7615 Colony Rd Ste 115
Charlotte, NC 28226-5001

Phone

(704) 626-6812

Fax

(704) 626-6824

NPI assigned

Jul 4, 2006

Organization subpart

No

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

Authorized official

Name

Jay Fernando, M.D.

Title

Physician

Phone

(704) 378-4357

Specialties & licenses 1

Addresses

Other identifiers 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573516800000",
    "number": "1538199567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7615 COLONY RD STE 115",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282265001",
            "telephone_number": "704-378-4357",
            "fax_number": "704-626-6824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7615 COLONY RD STE 115",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282265001",
            "telephone_number": "704-626-6812",
            "fax_number": "704-626-6824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA PHYSICIANS GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2019-11-12",
        "status": "A",
        "authorized_official_last_name": "FERNANDO",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "704-378-4357",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "0099-01172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891235U",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8912356",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolina Pain Associates, PA
• Carolina Parenting Solutions, PLLC
• Carolina Path to Progress
• Carolina Pharmacy
• Carolina Physical Medicine PC
• Carolina Podiatry Group, Inc.
• Carolina Premier Care Group LLC
• Carolina Psychiatric Associates, PA
• Carolina Psychiatry and Addiction Services PLLC
• Carolina Psychological Institute, PLLC

• Internal Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.