North Carolina Neuropsychiatry

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

Legal business name

NORTH CAROLINA NEUROPSYCHIATRY

Practice address

6911 Shannon Willow Rd Ste 400
Charlotte, NC 28226-1350

Phone

(980) 296-2211

Fax

(984) 235-1617

NPI assigned

Sep 7, 2010

Organization subpart

No

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

Authorized official

Name

Tiffany Clark

Title

Administrator

Phone

(919) 785-5055

Specialties & licenses 3

Addresses

Other identifiers 1

Tax ID family

North Carolina Neuropsychiatry3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• North Carolina Neuropsychiatry

  • Child & Adolescent Psychiatry Physician
  • Raleigh, NC
  • NPI 1659688059
  NPD tax ID
• North Carolina Neuropsychiatry, P.a.

  • Psychiatry Physician
  • Apex, NC
  • NPI 1003432121
  NPD tax ID

Locations

Practitioners 3

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

• Rebecca Kraus Barbee, PA-C

  • Physician Assistant
  • Davidson, NC
  • NPI 1427301027
  NPD (past)
• Camillo Thomas Gualtieri, MD

  • Neurology Physician
  • Chapel Hill, NC
  • NPI 1083684732
  NPD (past)
• Sarah E. Herndon, M.D.

  • Psychiatry Physician
  • Charlotte, NC
  • NPI 1861403339
  NPD (past)

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677110400000",
    "number": "1811204217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6911 SHANNON WILLOW RD STE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282261350",
            "telephone_number": "980-296-2211",
            "fax_number": "984-235-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6911 SHANNON WILLOW RD STE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282261350",
            "telephone_number": "980-296-2211",
            "fax_number": "984-235-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA NEUROPSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-07",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-785-5055"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "230737",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Carolina Integrated Services LLC
• North Carolina Life of Rehabilitation, Inc.
• North Carolina Medical Specialists PC
• North Carolina Mental Health Providers and Professionals
• North Carolina Neurodiagnostics, LLC
• North Carolina Phlebology PC
• North Carolina Physicians Eyecare Group, P.C.
• North Carolina Total Home Care
• North Carolina Total Home Care Behavioral Health Services Inc
• North Charlotte Family Medicine PLLC

• All providers in Charlotte, NC
• Child & Adolescent Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.