Charlotte Primary Services Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CHARLOTTE PRIMARY SERVICES INC.

Practice address

1235 East Blvd
Charlotte, NC 28203-5870

Phone

(252) 470-8358

NPI assigned

Nov 30, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Gonzalo Olivera

Title

President

Phone

(704) 763-5948

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1259539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262649600000",
    "number": "1710215959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 85073",
            "address_2": "# 51164",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232855073",
            "telephone_number": "704-763-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 EAST BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035870",
            "telephone_number": "252-470-8358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE PRIMARY SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-30",
        "last_updated": "2010-01-05",
        "status": "A",
        "authorized_official_last_name": "OLIVERA",
        "authorized_official_first_name": "GONZALO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-763-5948",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Jan 5, 2010; 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.