Individual provider Active NPI

Brian E Coyle, MD

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1649244724
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2021-00647 Issued in NC
Practice address
416 McCullough Dr Ste 140
Charlotte, NC 28262-4390
Phone
(704) 717-3383
Fax
(704) 717-3393
NPI assigned
Feb 15, 2006
Last updated
Mar 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 28673 TN
Pediatrics Physician 208000000X 2021-00647 NC Primary

Addresses

Primary practice location

416 McCullough Dr Ste 140
Charlotte, NC 28262-4390

Mailing address

416 McCullough Dr Ste 140
Charlotte, NC 28262-4390
Phone (704) 717-3383

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

LicenseStateTypeSpecialty
2021-00647NCMDPediatrics Physician
28673TNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skyridge Clinical Associates, LLC Pediatrics Past Accepting new patients
Peerless Pediatrics, PLLC Pediatrics Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/0626300

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1649244724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 MCCULLOUGH DR STE 140",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624390",
            "telephone_number": "704-717-3383",
            "fax_number": "707-717-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 MCCULLOUGH DR STE 140",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624390",
            "telephone_number": "704-717-3383",
            "fax_number": "704-717-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYLE",
        "first_name": "BRIAN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "28673",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2021-00647",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 8, 2021; 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.