Mountain Island Family Medicine, PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

125435 Issued in NC

Legal business name

MOUNTAIN ISLAND FAMILY MEDICINE, PC

Practice address

10226 Couloak Dr
Suite 110
Charlotte, NC 28216-7675

Phone

(704) 399-1415

Fax

(704) 399-1415

NPI assigned

Aug 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Clayton R Bailey, MD

Title

President

Phone

(704) 399-1415

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296604800000",
    "number": "1669664264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10226 COULOAK DR",
            "address_2": "SUITE 110",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282167675",
            "telephone_number": "704-399-1415",
            "fax_number": "704-399-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10226 COULOAK DR",
            "address_2": "SUITE 110",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282167675",
            "telephone_number": "704-399-1415",
            "fax_number": "704-399-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN ISLAND FAMILY MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-16",
        "last_updated": "2011-02-02",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-399-1415",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "125435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sanita A Moulton, M.A.C.C., LMFT
• Shannell Sintell Moultrie, NP
• Mohammed Moumen, MD
• Mount Eagle Health Care-Charlotte, LLC
• Mountain Island Chiropractic
• Mountain Summit Medical LLC
• Mountain View Medical Services (University Senior Health Services)
• Mark Mounts II
• Rajesh Mourya, MBBS
• Essam Mouta

• Primary Care Clinic/Center in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Primary Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; 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.