Individual provider Active NPI

Julia Marie Funck, DO

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1609335611
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2022-02035 Issued in NC
Practice address
5740 N Graham St
Charlotte, NC 28269-4839
Phone
(704) 251-8341
Fax
(980) 549-3832
NPI assigned
Mar 19, 2019
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2022-02035 NC Primary

Addresses

Primary practice location

5740 N Graham St
Charlotte, NC 28269-4839

Mailing address

932 Habersham Dr
Charlotte, NC 28209-1306

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220906000165 NC Practitioner - Internal Medicine 4183950439 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center Internal Medicine CurrentSince Aug 19, 2024 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Medical Center CurrentSince Aug 19, 2024 Accepting new patients

Locations

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

1350 S Kings Dr
Fl 3
Charlotte, NC 28207
Phone (704) 446-1242

Organizations & group practices 3

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1609335611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 HABERSHAM DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282091306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5740 N GRAHAM ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282694839",
            "telephone_number": "704-251-8341",
            "fax_number": "980-549-3832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNCK",
        "first_name": "JULIA",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2022-02035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.