NPIMap

Organization Active NPI

Mecklenburg Dermatology Assoc. PA

  • Specialist
  • Charlotte, NC
National Provider Identifier
1831176643
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
9400642 Issued in NC
Legal business name
MECKLENBURG DERMATOLOGY ASSOC. PA
Practice address
309 S. Sharon Amity
Suite 200
Charlotte, NC 28211-0000
Phone
(704) 344-8846
Fax
(704) 344-9844
NPI assigned
Dec 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

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

Authorized official

Name
Ms. Sharon M. Swartz, PA-CNPI 1215903117
Title
Office Manager
Phone
(704) 344-8846

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 9400642 NC Primary

Addresses

Primary practice location

309 S. Sharon Amity
Suite 200
Charlotte, NC 28211-0000

Mailing address

309 S. Sharon Amity
Suite 200
Charlotte, NC 28211-0000
Phone (704) 344-8846

Other identifiers 4

IdentifierTypeStateIssuer
8952485MedicaidNC
897835EMedicaidNC
89011AXMedicaidNC
5902119MedicaidNC

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340668800000",
    "number": "1831176643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 S. SHARON AMITY",
            "address_2": "SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282110000",
            "telephone_number": "704-344-8846",
            "fax_number": "704-369-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 S. SHARON AMITY",
            "address_2": "SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282110000",
            "telephone_number": "704-344-8846",
            "fax_number": "704-344-9844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECKLENBURG DERMATOLOGY ASSOC. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2012-06-26",
        "status": "A",
        "authorized_official_last_name": "SWARTZ",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "704-344-8846",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NC",
            "license": "9400642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8952485",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "897835E",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89011AX",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902119",
            "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 Jun 26, 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.