Family Healthcare of Lake Norman PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9801807 Issued in NC

Legal business name

FAMILY HEALTHCARE OF LAKE NORMAN PC

Practice address

9718 Sam Furr Rd
Ste. a
Huntersville, NC 28078-4978

Phone

(704) 987-7970

Fax

(704) 987-8221

NPI assigned

Jan 9, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Vincent Mark Winegardner

Title

Administrator

Phone

(704) 987-7970

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Linda Still Winegardner, MD

  • Family Medicine Physician
  • Huntersville, NC
  • NPI 1336147024
  Medicare reassignment NPD

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217894400000",
    "number": "1770768665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9718 SAM FURR RD",
            "address_2": "STE. A",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280784978",
            "telephone_number": "704-987-7970",
            "fax_number": "704-987-8221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9718 SAM FURR RD",
            "address_2": "STE. A",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280784978",
            "telephone_number": "704-987-7970",
            "fax_number": "704-987-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTHCARE OF LAKE NORMAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-08-05",
        "status": "A",
        "authorized_official_last_name": "WINEGARDNER",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-987-7970",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9801807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891178M",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• John Fani Srour, M.D.
• Krishon L Farley, CD, CLC
• Candace Mayberry Farmer, MSW, LCSW
• Kendall Cecilia Farr, MS RD LDN
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• Family Medicine Physician in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.