First Family Medical LLP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2006-01193 Issued in NC

Legal business name

FIRST FAMILY MEDICAL LLP

Practice address

1928 Randolph Rd
Ste 206
Charlotte, NC 28207-1105

Phone

(704) 332-3350

NPI assigned

Apr 28, 2014

Organization subpart

No

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

Authorized official

Name

Michael Nettles

Title

Office Manager

Phone

(704) 332-3350

Specialties & licenses 7

Addresses

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398643200000",
    "number": "1700296951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1928 RANDOLPH RD",
            "address_2": "STE 206",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071105",
            "telephone_number": "704-332-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1928 RANDOLPH RD",
            "address_2": "STE 206",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071105",
            "telephone_number": "704-332-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST FAMILY MEDICAL LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-28",
        "last_updated": "2014-04-28",
        "status": "A",
        "authorized_official_last_name": "NETTLES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "704-332-3350"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2006-01193",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2006-01193",
            "primary": false
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "NC",
            "license": "2006-01193",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2006-01193",
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "NC",
            "license": "2006-01193",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NC",
            "license": "2006-01193",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology",
            "state": "NC",
            "license": "2006-01193",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; 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.