Individual provider Active NPI

Ivan Carrion

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1760487292
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
30789 Issued in NC
Practice address
7800 Providence Rd
Suite 203
Charlotte, NC 28226-2952
Phone
(704) 512-2610
NPI assigned
Jun 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 30789 NC Primary

Addresses

Primary practice location

7800 Providence Rd
Suite 203
Charlotte, NC 28226-2952

Mailing address

7800 Providence Rd
Charlotte, NC 28226-2952

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180214001922 NC Practitioner - Pediatric Medicine 7911267885 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Pediatrics CurrentSince Dec 27, 2017 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 27, 2017 Accepting new patients
Charlotte Pediatric Clinic Pediatrics Current Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc PastSince Jan 15, 2018 Accepting new patients

Locations

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

7800 Providence Rd
Ste 203
Charlotte, NC 28226
Phone (704) 512-2610

7800 Providence Rd
Charlotte, NC 28226
Phone (704) 512-2610

13640 Steelecroft Pkwy
Ste 210
Charlotte, NC 28278
Phone (704) 512-6100

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1760487292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 PROVIDENCE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282262952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 PROVIDENCE RD",
            "address_2": "SUITE 203",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282262952",
            "telephone_number": "704-512-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRION",
        "first_name": "IVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "30789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.