Neogenix Lake Norman, PC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

NEOGENIX LAKE NORMAN, PC

Practice address

19475 Old Jetton Rd Ste 102
Cornelius, NC 28031-6591

Phone

(704) 727-6551

Fax

(704) 669-8670

NPI assigned

Nov 11, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Nikitas William Miles

Title

Director of Operations

Phone

(704) 727-6551

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1730903436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16147 LANCASTER HWY STE 140",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774782",
            "telephone_number": "704-727-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19475 OLD JETTON RD STE 102",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280316591",
            "telephone_number": "704-727-6551",
            "fax_number": "704-669-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEOGENIX LAKE NORMAN, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "MILES",
        "authorized_official_first_name": "NIKITAS",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "704-727-6551",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Dimmock Nappier, LCSW
• Patricia J. Naso, LCSW
• Breanna S Neal
• Jessica Neikirk, DC
• Allyson Nelson, PT, DPT
• Patrice Nerone, LCPC
• Newlife Counseling and Consultation, PLLC
• Lisa Tuyet Nguyen, LCMHC-A
• Emily Carolyn Nichols, FNP-BC
• Jessica Nickolson, OTR

• Medical Specialty Clinic/Center in Cornelius, NC
• Providers in Cornelius, NC by specialty
• Medical Specialty Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.