Charlotte Medical Clinic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CHARLOTTE MEDICAL CLINIC

Practice address

10545 Blair Road
Suite 2100
Mint Hill, NC 28227-2804

Phone

(704) 863-9500

Fax

(704) 863-9501

NPI assigned

Dec 17, 2009

Last updated

Oct 24, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Daniel L. Wiens

Title

Senior Vice President

Phone

(704) 355-0648

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Carolinas Physicians Network Inc

  dba Atrium Health Primary Care North Charlotte Internal Medicine

  • Internal Medicine Physician
  • Huntersville, NC
  • NPI 1730362641

  Member Of

  NPD member
• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Stanly

  • General Acute Care Hospital
  • Albemarle, NC
  • NPI 1144688219

  Member Of

  NPD member

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351036800000",
    "number": "1780913921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601643",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601643",
            "telephone_number": "704-512-4808",
            "fax_number": "704-512-4838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10545 BLAIR ROAD",
            "address_2": "SUITE 2100",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282272804",
            "telephone_number": "704-863-9500",
            "fax_number": "704-863-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-17",
        "last_updated": "2012-10-24",
        "status": "A",
        "authorized_official_last_name": "WIENS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "704-355-0648"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908921",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolinas Physicians Network Inc (The Sanger Clinic)
• Carolinas Physicians Network Inc (Greater Carolinas Womens Center)
• Carolinas Physicians Network, Inc. (Union Endocrinology Associates)
• Catherine B. Laws, D.D.S., P.L.L.C. (Town Dental Group)
• Conor Charles Chambers
• Charlotte Medical Clinic Inc
• Charlotte-Mecklenburg Hospital Authority (CMC Orthopaedic Surgery-Union)
• Jenny L. Chen, MD
• Hattie Lynnette Cherry
• Sylvana Chimenti, DMD

• Internal Medicine Physician in Mint Hill, NC
• Providers in Mint Hill, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; 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.