NPIMap

Organization Active NPI

Kidzcare Pediatrics, PC

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1821419508
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
118386 Issued in NC
Legal business name
KIDZCARE PEDIATRICS, PC
Practice address
5244B N Sharon Amity Rd
Charlotte, NC 28215-0053
Phone
(704) 536-0073
Fax
(704) 535-5722
NPI assigned
Dec 23, 2013
Last updated
Jul 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

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

Authorized official

Name
Ms. Rebecca E Wright
Title
Credentials Manager
Phone
(910) 483-7337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 118386 NC Primary

Addresses

Primary practice location

5244B N Sharon Amity Rd
Charlotte, NC 28215-0053

Mailing address

PO Box 647
Hope Mills, NC 28348-0647
Phone (910) 483-7337

Other identifiers 12

IdentifierTypeStateIssuer
1821419508OtherNCTRICARE
7578540OtherNCAETNA
9473694OtherNCPHCS MULTIPLAN
016VROtherNCBCBS OF NC
1821419508OtherNCCOVENTRY CAROLINAS, PPO, NATIONAL
1821419508OtherNCFIRST CAROLINA CARE
1821419508MedicaidNC
2775124OtherNCUNITED HEALTHCARE
1821419508OtherNCHEALTHSMART
1821419508OtherNCHUMANA
4142710OtherNCCIGNA GREATWEST
1821419508OtherNCMEDCOST

National Provider Directory

National Provider Directory
Tax ID family
Kidzcare Pediatrics PC28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Locations

5244B N Sharon Amity Rd
Charlotte, NC 28215
Phone (704) 536-0073

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1387756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437004800000",
    "number": "1821419508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 647",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283480647",
            "telephone_number": "910-483-7337",
            "fax_number": "910-483-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5244B N SHARON AMITY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282150053",
            "telephone_number": "704-536-0073",
            "fax_number": "704-535-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDZCARE PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-23",
        "last_updated": "2015-07-16",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CREDENTIALS MANAGER",
        "authorized_official_telephone_number": "910-483-7337",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "118386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1821419508",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7578540",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS MULTIPLAN",
            "identifier": "9473694",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "016VR",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY CAROLINAS, PPO, NATIONAL",
            "identifier": "1821419508",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CAROLINA CARE",
            "identifier": "1821419508",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821419508",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2775124",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSMART",
            "identifier": "1821419508",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "1821419508",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA GREATWEST",
            "identifier": "4142710",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "1821419508",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.